Cerebral Arterial Network Research Articles

Identifying hemodynamic factors associated with the rupture of anterior communicating artery aneurysms based on global modeling of blood flow in the cerebral artery network

Anterior communicating artery (ACoA) aneurysms are more prone to rupture compared to aneurysms present in other cerebral arteries. We hypothesize that systemic blood flow in the cerebral artery network plays an important role in shaping intra-aneurysmal hemodynamic environment thereby affecting the rupture risk of ACoA aneurysms. The majority of existing numerical studies in this field employed local modeling methods where the physical boundaries of a model are confined to the aneurysm region, which, though having the benefit of reducing computational cost, may compromise the physiological fidelity of numerical results due to insufficient account of systemic cerebral arterial hemodynamics. In the present study, we firstly carried out numerical experiments to address the difference between the outcomes of local and global modeling methods, demonstrating that local modeling confined to the aneurysm region results in inaccurate predictions of hemodynamic parameters compared with global modeling of the ACoA aneurysm as part of the cerebral artery network. Motivated by this finding, we built global hemodynamic models for 40 ACoA aneurysms (including 20 ruptured and 20 unruptured ones) based on medical image data. Statistical analysis of the computed hemodynamic data revealed that maximum wall shear stress (WSS), minimum WSS divergence, and maximum WSS gradient differed significantly between the ruptured and unruptured ACoA aneurysms. Optimal threshold values of high/low WSS metrics were determined through a series of statistical tests. In the meantime, some morphological parameters of aneurysms, such as large nonsphericity index, aspect ratio, and bottleneck factor, were found to be associated closely with aneurysm rupture. Furthermore, multivariate logistic regression analyses were performed to derive models combining hemodynamic and morphological parameters for discriminating the rupture status of aneurysms. The capability of the models in rupture status discrimination was high, with the area under the receiver operating characteristic curve reaching up to 0.9. The findings of the study suggest that global modeling of the cerebral artery network is essential for reliable quantification of hemodynamics in ACoA aneurysms, disturbed WSS and irregular aneurysm morphology are associated closely with aneurysm rupture, and multivariate models integrating hemodynamic and morphological parameters have high potential for assessing the rupture risk of ACoA aneurysms.

Cerebral arterial stiffness is linked to white matter hyperintensities and perivascular spaces in older adults – A 4D flow MRI study

White matter hyperintensities (WMH), perivascular spaces (PVS) and lacunes are common MRI features of small vessel disease (SVD). However, no shared underlying pathological mechanism has been identified. We investigated whether SVD burden, in terms of WMH, PVS and lacune status, was related to changes in the cerebral arterial wall by applying global cerebral pulse wave velocity (gcPWV) measurements, a newly described marker of cerebral vascular stiffness. In a population-based cohort of 190 individuals, 66–85 years old, SVD features were estimated from T1-weighted and FLAIR images while gcPWV was estimated from 4D flow MRI data. Additionally, the gcPWV’s stability to variations in field-of-view was analyzed. The gcPWV was 10.82 (3.94) m/s and displayed a significant correlation to WMH and white matter PVS volume (r = 0.29, p < 0.001; r = 0.21, p = 0.004 respectively from nonparametric tests) that persisted after adjusting for age, blood pressure variables, body mass index, ApoB/A1 ratio, smoking as well as cerebral pulsatility index, a previously suggested early marker of SVD. The gcPWV displayed satisfactory stability to field-of-view variations. Our results suggest that SVD is accompanied by changes in the cerebral arterial wall that can be captured by considering the velocity of the pulse wave transmission through the cerebral arterial network.

Trend of cerebral aneurysms over the past two centuries: need for early screening

ObjectiveCerebral aneurysms (CAs) are linked to variations in the cerebral basal arterial network (CBAN). This study aimed to find the optimal age for screening to detect brain arterial variations and...

Associations of Intracranial Artery Length and Branch Number on Time-of-Flight MRA With Cognitive Impairment in Hypertensive Older Males.

Hypertension-induced impairment of the cerebral artery network contributes to cognitive impairment. Characterizing the structure and function of cerebral arteries may facilitate the understanding of hypertension-related pathological mechanisms and lead to the development of new indicators for cognitive impairment. To investigate the associations between morphological features of the intracranial arteries distal to the circle of Willis on time-of-flight MRA (TOF-MRA) and cognitive performance in a hypertensive cohort. Prospective observational study. 189 hypertensive older males (mean age 64.9 ± 7.2 years). TOF-MRA sequence with a 3D spoiled gradient echo readout and arterial spin labeling perfusion imaging sequence with a 3D stack-of-spirals fast spin echo readout at 3T. The intracranial arteries were segmented from TOF-MRA and the total length of distal arteries (TLoDA) and number of arterial branches (NoB) were calculated. The mean gray matter cerebral blood flow (GM-CBF) was extracted from arterial spin labeling perfusion imaging. The cognitive level was assessed with short-term and long-term delay-recall auditory verbal learning test (AVLT) scores, and with montreal cognitive assessment. Univariable and multivariable linear regression were used to analyze the associations between TLoDA, NoB, GM-CBF and the cognitive assessment scores, with P < 0.05 indicating significance. TLoDA (r = 0.314) and NoB (r = 0.346) were significantly correlated with GM-CBF. Multivariable linear regression analyses showed that TLoDA and NoB, but not GM-CBF (P = 0.272 and 0.141), were significantly associated with short-term and long-term delay-recall AVLT scores. These associations remained significant after adjusting for GM-CBF. The TLoDA and NoB of distal intracranial arteries on TOF-MRA are significantly associated with cognitive impairment in hypertensive subjects. 2 TECHNICAL EFFICACY: Stage 3.

Computational modeling of multiscale collateral blood supply in a whole-brain-scale arterial network.

The cerebral arterial network covering the brain cortex has multiscale anastomosis structures with sparse intermediate anastomoses (O[102] μm in diameter) and dense pial networks (O[101] μm in diameter). Recent studies indicate that collateral blood supply by cerebral arterial anastomoses has an essential role in the prognosis of acute ischemic stroke caused by large vessel occlusion. However, the physiological importance of these multiscale morphological properties-and especially of intermediate anastomoses-is poorly understood because of innate structural complexities. In this study, a computational model of multiscale anastomoses in whole-brain-scale cerebral arterial networks was developed and used to evaluate collateral blood supply by anastomoses during middle cerebral artery occlusion. Morphologically validated cerebral arterial networks were constructed by combining medical imaging data and mathematical modeling. Sparse intermediate anastomoses were assigned between adjacent main arterial branches; the pial arterial network was modeled as a dense network structure. Blood flow distributions in the arterial network during middle cerebral artery occlusion simulations were computed. Collateral blood supply by intermediate anastomoses increased sharply with increasing numbers of anastomoses and provided one-order-higher flow recoveries to the occluded region (15%-30%) compared with simulations using a pial network only, even with a small number of intermediate anastomoses (≤10). These findings demonstrate the importance of sparse intermediate anastomoses, which are generally considered redundant structures in cerebral infarction, and provide insights into the physiological significance of the multiscale properties of arterial anastomoses.

Development and blood flow analysis of the whole cerebral artery network with intraparenchymal anastomoses

Development and blood flow analysis of the whole cerebral artery network with intraparenchymal anastomoses

Combination of Morphological and Hemodynamic Parameters for Assessing the Rupture Risk of Intracranial Aneurysms: A Retrospective Study on Mirror Middle Cerebral Artery Aneurysms.

Discordant findings were frequently reported by studies dedicated to exploring the association of morphological/hemodynamic factors with the rupture of intracranial aneurysms (IAs), probably owing to insufficient control of confounding factors. In this study, we aimed to minimize the influences of confounding factors by focusing IAs of interest on mirror aneurysms and, meanwhile, modeling IAs together with the cerebral arterial network to improve the physiological fidelity of hemodynamic simulation. Fifty-two mirror aneurysms located at the middle cerebral artery (MCA) in 26 patients were retrospectively investigated. Numerical tests performed on two randomly selected patients demonstrated that over truncation of cerebral arteries proximal to the MCA during image-based model reconstruction led to uncertain changes in computed values of intra-aneurysmal hemodynamic parameters, which justified the minimal truncation strategy adopted in our study. Five morphological parameters (i.e., volume (V), height (H), dome area (DA), nonsphericity index (NSI), and size ratio (SR)) and two hemodynamic parameters (i.e., peak wall shear stress (WSS) (peakWSS), and pressure loss coefficient (PLc)) were found to differ significantly between the ruptured and unruptured aneurysms and proved by receiver operating characteristic (ROC) analysis to have potential value for differentiating the rupture status of aneurysm with the areas under curve (AUCs) ranging from 0.681 to 0.763. Integrating V, SR, peakWSS, and PLc or some of them into regression models considerably improved the classification of aneurysms, elevating AUC up to 0.864, which indicates that morphological and hemodynamic parameters have complementary roles in assessing the risk of aneurysm rupture.

Comparison of algorithms for estimating blood flow velocities in cerebral arteries based on the transport information of contrast agent: An in silico study

While many algorithms have been proposed to estimate blood flow velocities based on the transport information of contrast agent acquired by digital subtraction angiography (DSA), most relevant studies focused on a single vessel, leaving a question open as to whether the algorithms would be suitable for estimating blood flow velocities in arterial systems with complex topological structures. In this study, a one-dimensional (1-D) modeling method was developed to simulate the transport of contrast agent in cerebral arterial networks with various anatomical variations or having occlusive disease, thereby generating an in silico database for examining the accuracies of some typical algorithms (i.e., time-of-center of gravity (TCG), shifted least-squares (SLS), and cross correlation (CC) algorithms) that estimate blood flow velocity based on the concentration-time curves (CTCs) of contrast agent. The results showed that the TCG algorithm had the best performance in estimating blood flow velocities in most cerebral arteries, with the accuracy being only mildly affected by anatomical variations of the cerebral arterial network. Nevertheless, the presence of a stenosis of moderate to high severity in the internal carotid artery could considerably impair the accuracy of the TCG algorithm in estimating blood flow velocities in some cerebral arteries where the transport of contrast agent was disturbed by strong collateral flows. In summary, the study suggests that the TCG algorithm may offer a promising means for estimating blood flow velocities based on CTCs of contrast agent monitored in cerebral arteries, provided that the shapes of CTCs are not highly distorted by collateral flows.

Relationship between cerebral aneurysms and variations in cerebral basal arterial network: a morphometric cross-sectional study in Computed Tomography Angiograms from a neurointerventional unit

ObjectiveSegments of cerebral basal arterial network (CBAN) dampen the peak pressure in blood flowing through these arteries, thus minimising the chances of development of cerebral aneurysms. The objective of this...

Well-Formed Segmental Cerebral Arteries Dampen the Peak Systolic Pressure Lowering the Chances of Aneurysms

Background: The segments of cerebral basal arterial network (CBAN) dampen the peak systolic pressure in blood flowing through these arteries. The number of aneurysms occurring in segments of CBAN will vary with the ability of each arterial segment to dampen the peak systolic pressure. Materials and Methods: Diameters of segments of CBAN were measured in cerebral computed tomography angiography images of 145 patients and the relative size of each vessel was calculated to standardise for differences in overall arterial sizes among patients. Relationships among sizes of CBAN components were statistically analysed. Presence of aneurysms in parts of internal carotid artery (ICA), middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and vertebrobasilar (VB) arteries was recorded. Results: Forty-six aneurysms in right ICA and MCA and 32 aneurysms in left ICA and MCA segments were noted in 42 and 30 patients, respectively. Aneurysms in anterior communicating artery complex (AcomAC) and VB arterial segments were seen in 27 and 8 patients respectively, while they were not detected in parts of PCA. The significant (p<0·0001) inverse relationships between sizes of posterior communicating artery (PcomA) and the first segment of PCA on both sides indicated that blood inputs to the second part of PCA were similar. This smoothens vessels haemodynamics. Differences in means of the index of arterial size variation for people with aneurysms (0·96) and without aneurysms (0·86) was significant (p≤0·015). Aneurysms in ACA, PCA and VB arteries were less and was proposed that it is due to dampening of peak systolic blood pressures. The development of aneurysms occurring in CBAN depended on the degree of variation and asymmetry in its segments. Conclusion: Variation in segments of CBAN has been quantified. The peak pressure dampening mechanism in such arterial segments reduces the chances of development of aneurysms. Funding: None to declare Declaration of Interest: There is no conflict of interest with any of the authors. Ethical Approval: Randomly selected CCTA images of 145 patients archived in the Carestream data registry system at Royal Adelaide Hospital (RAH), South Australia between January 2011 and December 2019, were used in the study (male = 67, female = 78, mean age = 60·9 years) (Supplementary file 1). Human Research Ethics Board granted permission (approval number: H2014 -176) to access and use data from the Carestream data registry system (Vue RIS version 11·0·14·35).

Anterior Communicating Artery Complex Aneurysms Are Caused by the Asymmetric Anterior Cerebral Arteries

Background: Rupture of anterior communicating artery complex (AcomAC) aneurysms is a common cause of haemorrhagic brain strokes. Ability to predict development of aneurysms in advance would allow stroke prevention. Asymmetry of the components of cerebral basal arterial network (CBAN) could alter hemodynamics and may contribute to formation of aneurysms. The asymmetric diameter ratio of first segments of anterior cerebral arteries (A1s), correlates with the occurrence of the AcomAC aneurysms. Materials and Methods: Cerebral Computed Tomography Angiography (CTA) scans of 166 adult patients of both sexes were studied. The internal diameters of the right and left A1 segments of anterior cerebral arteries, perpendicular to the long axis of the vessels were measured. Positions and presence or absence of aneurysms in AcomAC were recorded in each individual case. The ratio of the larger to the smaller A1 diameters was determined as a measure of the asymmetry of A1 segments of anterior cerebral arteries (ACAs). Findings: The risk of development of aneurysms in AcomAC was much greater (risk 80%, odds ratio = 47·3) when one A1 segment's radius was at least 50% larger (i.e. 2·25 times greater cross-sectional area) than the other. The risk of development of aneurysms was just 7·8%, if the A1 asymmetric ratio was less than 1·5 (odds ratio = 0·02). Conclusion: The asymmetry ratio of the A1 segments of anterior cerebral arteries is a good predictor for the development of aneurysms in the AcomAC region. Funding Statement: The authors stated: None. Declaration of Interests: The authors declare that there is no conflict of interests. Ethics Approval Statement: The use of images and accompanying information was approved for research purposes by the University of Adelaide Human Research Ethics Board (approval number: H2014-176). Patients’ personal details, have not been copied, documented, or included in this research.

Intercellular Conduction Optimizes Arterial Network Function and Conserves Blood Flow Homeostasis During Cerebrovascular Challenges.

Cerebral arterial networks match blood flow delivery with neural activity. Neurovascular response begins with a stimulus and a focal change in vessel diameter, which by themselves is inconsequential to blood flow magnitude, until they spread and alter the contractile status of neighboring arterial segments. We sought to define the mechanisms underlying integrated vascular behavior and considered the role of intercellular electrical signaling in this phenomenon. Approach and Results: Electron microscopic and histochemical analysis revealed the structural coupling of cerebrovascular cells and the expression of gap junctional subunits at the cell interfaces, enabling intercellular signaling among vascular cells. Indeed, robust vasomotor conduction was detected in human and mice cerebral arteries after focal vessel stimulation: a response attributed to endothelial gap junctional communication, as its genetic alteration attenuated this behavior. Conducted responses were observed to ascend from the penetrating arterioles, influencing the contractile status of cortical surface vessels, in a simulated model of cerebral arterial network. Ascending responses recognized in vivo after whisker stimulation were significantly attenuated in mice with altered endothelial gap junctional signaling confirming that gap junctional communication drives integrated vessel responses. The diminishment in vascular communication also impaired the critical ability of the cerebral vasculature to maintain blood flow homeostasis and hence tissue viability after stroke. Our findings highlight the integral role of intercellular electrical signaling in transcribing focal stimuli into coordinated changes in cerebrovascular contractile activity and expose, a hitherto unknown mechanism for flow regulation after stroke.

CerebroVis: Designing an Abstract yet Spatially Contextualized Cerebral Artery Network Visualization.

Blood circulation in the human brain is supplied through a network of cerebral arteries. If a clinician suspects a patient has a stroke or other cerebrovascular condition, they order imaging tests. Neuroradiologists visually search the resulting scans for abnormalities. Their visual search tasks correspond to the abstract network analysis tasks of browsing and path following. To assist neuroradiologists in identifying cerebral artery abnormalities, we designed CerebroVis, a novel abstract-yet spatially contextualized-cerebral artery network visualization. In this design study, we contribute a novel framing and definition of the cerebral artery system in terms of network theory and characterize neuroradiologist domain goals as abstract visualization and network analysis tasks. Through an iterative, user-centered design process we developed an abstract network layout technique which incorporates cerebral artery spatial context. The abstract visualization enables increased domain task performance over 3D geometry representations, while including spatial context helps preserve the user's mental map of the underlying geometry. We provide open source implementations of our network layout technique and prototype cerebral artery visualization tool. We demonstrate the robustness of our technique by successfully laying out 61 open source brain scans. We evaluate the effectiveness of our layout through a mixed methods study with three neuroradiologists. In a formative controlled experiment our study participants used CerebroVis and a conventional 3D visualization to examine real cerebral artery imaging data to identify a simulated intracranial artery stenosis. Participants were more accurate at identifying stenoses using CerebroVis (absolute risk difference 13%). A free copy of this paper, the evaluation stimuli and data, and source code are available at osf.io/e5sxt.

Importance of incorporating systemic cerebroarterial hemodynamics into computational modeling of blood flow in intracranial aneurysm

The importance of properly treating boundary conditions (BCs) in numerical simulation of hemodynamics in intracranial aneurysm (IA) has been increasingly recognized. In this study, we constructed three types of computational model for each IA to investigate how the outcome of numerical simulation is affected by the treatment of BCs. The first type of model (i.e., Type-A model) was obtained by applying 3-D hemodynamic modeling to the entire cerebral arterial network, with its solution being taken as the reference for evaluating the performance of the other two types of model (i.e., Type-B and Type-C models) in which 3-D modeling was confined to the aneurysm region. In addition, patient-specific 1-D models of the cerebral arterial network were developed to provide hemodynamic information for setting the inflow/outflow BCs of the 3-D models. Numerical tests on three IAs revealed that prescribing the outflow BCs of a localized 3-D aneurysm model based on 1-D model-simulated outflow division (i.e., Type-B model) instead of imposing the free outflow BC on all outlets (i.e., Type-C model) helped to improve the fidelity of the simulation of intra-aneurysmal hemodynamics, but could not guarantee a complete reproduction of the reference solution obtained by the Type-A model. Moreover, it was found that the outcome of hemodynamic simulation was more sensitive to the treatment of BCs when an aneurysm was located at arterial bifurcation rather than sidewall. These findings highlight the importance of taking into account systemic cerebroarterial hemodynamics in computational modeling of hemodynamics in IAs, especially those located at bifurcations.

Systematization, Description and Territory of The Middle and Rostral Cerebral Arteries in Broad-Snouted Caimans (Caiman latirostris)

Background: Information on the arterial vascularization of the broad-snouted caimans’ brain (Caiman latirostris), a specie from the Brazilian fauna, is inexistent and the literature consulted yielded only one description about the development of embryonic circulation and post-birth cerebrovascular alterations in the brain of three caymans. The objective of this study was to describe and systematize the cerebral arterial vascularization of this reptile, by providing a standard irrigation model with its major variations, in addition to determining its territorial vascular areas. Materials, Methods & Results: Thirty heads of male broad-snouted caimans (Caiman latirostris), with the neck segment, were used in the study. Additionally, two whole female and male specimens, with approximately 3 years of age and weighing between 8 to 10 Kg were also used. The animals were sacrificed according to routine slaughterhouse norms. The heads were sectioned at the third cervical vertebra level and the azygos carotid artery was cannulated. The arterial system was washed with 0.9% saline solution and filled with red-colored latex. The pieces were fixed in formaldehyde and the encephalon removed through a window made in the cranial vault, which was followed by removal of the dura mater and dissection of the arteries. The internal carotid arteries displayed an intercarotic anastomosis in the samples examined, continuing rostrally in 100% of the cases, exiting from the skull as the internal ophthalmic artery. The internal carotid arteries divided into a rostral branch and a short caudal branch at the hypophysis level, which continued naturally as the caudal cerebral artery. The rostral branch from both right and left antimeres was shown as a single branch in 86.7% and as double branch in 13.3% of the samples, and it formed the middle cerebral artery network. The rostral cerebral artery represented the terminal branch of the internal carotid artery’s rostral branch, and an osculum anastomosis between its terminal end and its contralateral homologous artery occurred, forming the rostral communicating artery and thus closing the cerebral artery circle rostrally. Discussion: To support the results of the discussion, we used information available on the encephalic vascularization of turtles, lizards, iguanas and crocodiles, due to the absence of important publications about Caiman latirostris. One single source of blood supply, solely originated from the left aortic arch, was observed in the two whole specimens. This source was called the azygos carotid artery. Such denomination was given because these species did not show a typical common carotid artery, as the ventral part of the neck, up to the mandible, was vascularized by branches from the subclavian arteries. Therefore, we named this single and unique source as the azygos carotid artery. The cerebral arterial circle was rostrally closed by an anastomosis between the terminal ends of the rostral cerebral artery. Consequently, the blood supply to the brain was made exclusively by the carotid system. The main differences of the cerebral vascularization observed in caymans were: a network formation of the middle cerebral artery.

The cerebral basal arterial network: morphometry of inflow and outflow components.

The aim of this project was to study how the morphology of the incoming and outgoing arterial components of the cerebral basal arterial network influence the blood flow to the brain. The cerebral basal arterial network consists of the circulus arteriosus cerebri anteriorly and the basilar artery posteriorly. Diameters of inflow vessels (bilateral vertebral and internal carotid arteries), connecting vessels (anterior communicating, basilar and bilateral posterior communicating arteries) and outflow vessels (anterior, middle and posterior cerebral arteries) were measured and cross-sectional areas calculated in 51 cadaveric brain specimens. The individual and the average cross-sectional areas of inflow arteries (51.43mm2 ) were significantly bigger than the major outflow arteries (37.76mm2 ) but smaller than the combined cross-sectional areas of outflow (37.76mm2 ) and connecting (25.33mm2 ) arteries. The difference in the size of arterial cross-sectional area and the presence of the connecting arteries in the cerebral basal arterial network provides a mechanism for lowering peaks in pressure, and demonstrates a function of the cerebral basal arterial network.

The Dual Role of Cerebral Autoregulation and Collateral Flow in the Circle of Willis After Major Vessel Occlusion.

Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady-state model of the cerebral arterial network was created. Structural variants of the circle of Willis that present particular risk of stroke were recreated by using a network model coupled with: 1) a steady-state physiological model of cerebral autoregulation; and 2) one wherein the cerebral vascular bed was modeled as a passive resistance. Simulations were performed in various conditions of internal carotid and vertebral artery occlusion. Collateral flow alone is unable to ensure adequate blood flow ([Formula: see text] normal flow) to the cerebral arteries in several common variants during internal carotid artery occlusion. However, compared to a passive model, cerebral autoregulation is better able to exploit available collateral flow and maintain flows within [Formula: see text] of baseline. This is true for nearly all configurations. Hence, autoregulation is a crucial facilitator of collateral flow through the circle of Willis. Impairment of this response during ischemia will severely impact cerebral blood flows and tissue survival, and hence, autoregulation should be monitored in this situation.

Sensitivity of flow patterns in aneurysms on the anterior communicating artery to anatomic variations of the cerebral arterial network

Recent studies raised increasing concern about the reliability of computer models in reproducing in vivo hemodynamics in cerebral aneurysms. Boundary condition problem is among the most frequently addressed issues since three-dimensional (3-D) modeling is usually restricted to local arterial segments. The present study focused on aneurysms on the anterior communicating artery (ACoA) which represent a large subgroup of detected cerebral aneurysms and, in particular, have a relatively high risk of rupture compared to aneurysms located in other regions. The sensitivity of blood flows in three ACoA aneurysms to boundary conditions was investigated using 3-D hemodynamic models. The boundary conditions of the 3-D models were predicted by a one-dimensional (1-D) model of the cerebral arterial network. The parameters of the 1-D model were assigned based respectively on population-averaged data and patient-specific data derived from medical images, yielding a population-generic model and a patient-specific model. In addition, particle image velocimetry (PIV) experiments were performed to validate the code used to simulate intra-aneurysmal blood flows. Obtained results showed that switching the boundary conditions of the aneurysm models from population-generic ones to patient-specific ones led to pronounced changes in simulated intra-aneurysmal flow patterns in terms of vortex structure, impingement region and the magnitude and spatial distribution of wall shear stress and oscillatory shear index. In particular, the way and the degree in which hemodynamic quantities are influenced by boundary conditions exhibited pronounced inter-patient variability. In summary, our study underlines the importance of patient-specific treatment of boundary conditions in model studies focusing on ACoA aneurysms.

Three-dimensional hemodynamics analysis of the circle of Willis in the patient-specific nonintegral arterial structures

The hemodynamic alteration in the cerebral circulation caused by the geometric variations in the cerebral circulation arterial network of the circle of Wills (CoW) can lead to fatal ischemic attacks in the brain. The geometric variations due to impairment in the arterial network result in incomplete cerebral arterial structure of CoW and inadequate blood supply to the brain. Therefore, it is of great importance to understand the hemodynamics of the CoW, for efficiently and precisely evaluating the status of blood supply to the brain. In this paper, three-dimensional computational fluid dynamics of the main CoW vasculature coupled with zero-dimensional lumped parameter model boundary condition for the CoW outflow boundaries is developed for analysis of the blood flow distribution in the incomplete CoW cerebral arterial structures. The geometric models in our study cover the arterial segments from the aorta to the cerebral arteries, which can allow us to take into account the innate patient-specific resistance of the arterial trees. Numerical simulations of the governing fluid mechanics are performed to determine the CoW arterial structural hemodynamics, for illustrating the redistribution of the blood flow in CoW due to the structural variations. We have evaluated our coupling methodology in five patient-specific cases that were diagnosed with the absence of efferent vessels or impairment in the connective arteries in their CoWs. The velocity profiles calculated by our approach in the segments of the patient-specific arterial structures are found to be very close to the Doppler ultrasound measurements. The accuracy and consistency of our hemodynamic results have been improved (to [Formula: see text]%) compared to that of the pure-resistance boundary conditions (of 43.5 [Formula: see text] 28%). Based on our grouping of the five cases according to the occurrence of unilateral occlusion in vertebral arteries, the inter-comparison has shown that (i) the flow reduction in posterior cerebral arteries is the consequence of the unilateral vertebral arterial occlusion, and (ii) the flow rate in the anterior cerebral arteries is correlated with the posterior structural variations. This study shows that our coupling approach is capable of providing comprehensive information of the hemodynamic alterations in the pathological CoW arterial structures. The information generated by our methodology can enable evaluation of both the functional and structural status of the clinically significant symptoms, for assisting the treatment decision-making.

Analysis of mechanical parameters on the thromboembolism using a patient-specific computational model

Ischemic stroke is a major cause of death and long-term disabilities worldwide. In this paper, we aim to represent a comprehensive simulation of the motion of emboli through cerebrovascular network within patient-specific computational model. The model consists of major arteries of the circle of Willis reconstructed from magnetic resonance angiography images, pulsatile flow and emboli with different sizes and material properties. Here, the fluid-structure interactions method was used to simulate the motion of deformable and rigid emboli through cerebral arteries. Hemodynamic changes in the circle of Willis due to the entrance of embolus are observed. The effect of material properties on the distribution ratio and dynamics of motion of the emboli in the cerebral arterial network is also analyzed. Our results reveal that as the rigidity of emboli increases, higher proportion of them tend to enter to the larger arteries (e.g., middle cerebral artery). Scrutinizing the amount of stress acting on the emboli represented in this paper can broaden our understanding of the rheological phenomenon (e.g., lysis or growth of emboli during embolism). The approach of considering different material properties of the thrombus in a patient-specific computational model not only enable us to better understand the roll of biomechanical parameters causing the embolism, but also lead to a better clinical decision making to manage patients with stroke.