Middle cerebral artery pressure laterality in patients with symptomatic ICA stenosis.
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ABSTRACT: An internal carotid artery (ICA) stenosis can potentially decrease the perfusion pressure to the brain. In this study, computational fluid dynamics (CFD) was used to study if there was a hemispheric pressure laterality between the contra- and ipsilateral middle cerebral artery (MCA) in patients with a symptomatic ICA stenosis. We further investigated if this MCA pressure laterality (?PMCA) was related to the hemispheric flow laterality (?Q) in the anterior circulation, i.e., ICA, proximal MCA and the proximal anterior cerebral artery (ACA). Twenty-eight patients (73±6 years, range 59-80 years, 21 men) with symptomatic ICA stenosis were included. Flow rates were measured using 4D flow MRI data (PC-VIPR) and vessel geometries were obtained from computed tomography angiography. The ?PMCA was calculated from CFD, where patient-specific flow rates were applied at all input- and output boundaries. The ?PMCA between the contra- and ipsilateral side was 6.4±8.3 mmHg (p<0.001) (median 3.9 mmHg, range -1.3 to 31.9 mmHg). There was a linear correlation between the ?PMCA and ?QICA (r = 0.85, p<0.001) and ?QACA (r = 0.71, p<0.001), respectively. The correlation to ?QMCA was weaker (r = 0.47, p = 0.011). In conclusion, the MCA pressure laterality obtained with CFD, is a promising physiological biomarker that can grade the hemodynamic disturbance in patients with a symptomatic ICA stenosis.
SUBMITTER: Holmgren M
PROVIDER: S-EPMC7793245 | biostudies-literature | 2021
REPOSITORIES: biostudies-literature
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