Effects of progressive carotid stenosis on cerebral haemodynamics: aortic-cerebral 3D patient-specific simulation

Kang, Taehak; Mukherjee, Debanjan; Kim, Jeong‐Min; Park, Kwang‐Yeol; Ryu, Jaiyoung

doi:10.1080/19942060.2021.1916601

Cited by 7 publications

(2 citation statements)

References 80 publications

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“… Arterial blood pressure, PPG, and ICP waveforms in a 40-years old subject with 20% decrease of intracranial capacitance. The illustration of artery structure is adapted from ( Kang et al, 2021 ). …”

Section: Resultsmentioning

confidence: 99%

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Effect of intracranial pressure on photoplethysmographic waveform in different cerebral perfusion territories: A computational study

et al. 2023

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Background: Intracranial photoplethysmography (PPG) signals can be measured from extracranial sites using wearable sensors and may enable long-term non-invasive monitoring of intracranial pressure (ICP). However, it is still unknown if ICP changes can lead to waveform changes in intracranial PPG signals.Aim: To investigate the effect of ICP changes on the waveform of intracranial PPG signals of different cerebral perfusion territories.Methods: Based on lump-parameter Windkessel models, we developed a computational model consisting three interactive parts: cardiocerebral artery network, ICP model, and PPG model. We simulated ICP and PPG signals of three perfusion territories [anterior, middle, and posterior cerebral arteries (ACA, MCA, and PCA), all left side] in three ages (20, 40, and 60 years) and four intracranial capacitance conditions (normal, 20% decrease, 50% decrease, and 75% decrease). We calculated following PPG waveform features: maximum, minimum, mean, amplitude, min-to-max time, pulsatility index (PI), resistive index (RI), and max-to-mean ratio (MMR).Results: The simulated mean ICPs in normal condition were in the normal range (8.87–11.35 mm Hg), with larger PPG fluctuations in older subject and ACA/PCA territories. When intracranial capacitance decreased, the mean ICP increased above normal threshold (>20 mm Hg), with significant decreases in maximum, minimum, and mean; a minor decrease in amplitude; and no consistent change in min-to-max time, PI, RI, or MMR (maximal relative difference less than 2%) for PPG signals of all perfusion territories. There were significant effects of age and territory on all waveform features except age on mean.Conclusion: ICP values could significantly change the value-relevant (maximum, minimum, and amplitude) waveform features of PPG signals measured from different cerebral perfusion territories, with negligible effect on shape-relevant features (min-to-max time, PI, RI, and MMR). Age and measurement site could also significantly influence intracranial PPG waveform.

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Section: Resultsmentioning

confidence: 99%

“… The structure of cardiocerebral artery network and the boundary conditions. The illustration of artery structure is adapted from Figure 2 of ( Kang et al, 2021 ). …”

Section: Methodsmentioning

confidence: 99%

Effect of intracranial pressure on photoplethysmographic waveform in different cerebral perfusion territories: A computational study

et al. 2023

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Hemodynamic flow characteristics at stenosed artery: Numerical analysis of three-dimensional patient-specific aortic–cerebral vasculature exposed to progressive carotid stenosis

2022

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Progression of carotid stenosis (CS) significantly reduces blood flow in the affected arteries and alters both proximal and distal hemodynamics. While conventional studies consider only the stenosis region for analysis, an extended larger arterial domain of aortic–cerebral vasculature is used to avoid artificial modeling of the inlet condition to the carotid region and facilitate automatic flow redistribution during CS progression. The fluid domain was constructed and simulated using an open-source package SimVascular, and three patient models with five stenosis cases each were created using medical images. Newtonian, incompressible, and rigid-wall conditions were assumed because of the high computational burden, and boundary conditions of the lumped Windkessel and pulsatile flow rate were implemented for the outlets and inlet, respectively. We present a novel index called circulation core fraction (CCF) to quantify and visualize the stenosis-driven hemodynamics; the CCF is developed from the benchmark backward-facing step problem and compares the representative recirculation to the total volume. Thus, CCF in the post-stenotic region increases during CS progression regardless of patient-specific features whereas that in the pre-stenotic region exhibits patient-specific nature despite the incremental tendency. Streamlines with custom sources show a helical vortex with recirculation and artery-wise flow streams that vary during CS progression. We also report transitional patterns in both the pulsatility index (PI) contours and Q-criterion, where the PI values shift from high–low–high to high–low–low across the stenosis, and the latter is nearly absent at 0% and 95% but mostly present at 50% and 75% CS.

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Numerical investigation of carotid stenosis in three-dimensional aortic-cerebral vasculature: pulsatility index, resistive index, time to peak velocity, and flow characteristics

Kang

Mukherjee

Ryu

2021

Engineering Applications of Computational Fluid Mechanics

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Effects of progressive carotid stenosis on cerebral haemodynamics: aortic-cerebral 3D patient-specific simulation

Cited by 7 publications

References 80 publications

Effect of intracranial pressure on photoplethysmographic waveform in different cerebral perfusion territories: A computational study

Effect of intracranial pressure on photoplethysmographic waveform in different cerebral perfusion territories: A computational study

Hemodynamic flow characteristics at stenosed artery: Numerical analysis of three-dimensional patient-specific aortic–cerebral vasculature exposed to progressive carotid stenosis

Numerical investigation of carotid stenosis in three-dimensional aortic-cerebral vasculature: pulsatility index, resistive index, time to peak velocity, and flow characteristics

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