Computational fluid dynamics of computed tomography angiography to detect the hemodynamic impact of intracranial atherosclerotic stenosis

Abstract

Background: In symptomatic intracranial atherosclerotic stenosis (ICAS), its hemodynamic impact may affect the risk of stroke recurrence, in addition to the degree of luminal stenosis. We therefore conducted a pilot study to evaluate the feasibility to delineate the hemodynamic impact of symptomatic ICAS lesions using computational fluid dynamics (CFD) models reconstructed based on computed tomography angiography (CTA) source images. Methods: Three-dimensional CFD models were reconstructed based on routine CTA source images of patients with a symptomatic ICAS lesion. The anatomic features and hemodynamic impact of target ICAS lesions were evaluated on the CFD models. The hemodynamic impact of a lesion was evaluated using distal to proximal pressure ratio (PR) and pressure gradient (PG) across the lesion. PG was defined as pressure drop across the lesion divided by length of the lesion.

Hemodynamics and stroke risk in intracranial atherosclerotic disease

“…16,17 We have also indicated possible prognostic values of CFD model-generated hemodynamic metrics for the risk of recurrent stroke in a small cohort of 32 patients with 70 to 99% sICAS. 16,17 We have also indicated possible prognostic values of CFD model-generated hemodynamic metrics for the risk of recurrent stroke in a small cohort of 32 patients with 70 to 99% sICAS.…”

Semi‐automated analysis of 4D flow MRI to assess the hemodynamic impact of intracranial atherosclerotic disease

“…Pressure drop across the lesion has been proposed for assessing stroke risk . Patient‐specific computational fluid dynamic (CFD) modeling was used to compute the pressure drop across stenosis . The accuracy of CFD in replicating in vivo physiological flow depends on computational strategies and modeling assumptions .…”

Simulation Analysis of Blood Flow in Arteries of the Human Arm

“…1,2 Due to the close relation between hemodynamics and the various ailments in the human body, 3 Leng et al 4 and Saho and Onishi 5 simulated hemodynamics in 3D angiography cerebral models. They studied intracranial atherosclerotic stenosis and cerebral aneurysms, respectively, but results of Saho and Onishi indicated that the cause of cerebral aneurysms remained unclear.…”