Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke
Stroke is the third-most cause of death in developed countries. A new promising treatment method in case of an ischemic stroke is selective intracarotid blood cooling combined with mechanical artery recanalization. However, the control of the treatment requires invasive or MRI-assisted measurement o...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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De Gruyter
2019-09-01
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| Series: | Current Directions in Biomedical Engineering |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/cdbme-2019-0134 |
| _version_ | 1797989322512662528 |
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| author | Krames Lorena Daschner Rosa Lutz Yannick Loewe Axel Dössel Olaf Cattaneo Giorgio |
| author_facet | Krames Lorena Daschner Rosa Lutz Yannick Loewe Axel Dössel Olaf Cattaneo Giorgio |
| author_sort | Krames Lorena |
| collection | DOAJ |
| description | Stroke is the third-most cause of death in developed countries. A new promising treatment method in case of an ischemic stroke is selective intracarotid blood cooling combined with mechanical artery recanalization. However, the control of the treatment requires invasive or MRI-assisted measurement of cerebral temperature. An auspicious alternative is the use of computational modeling. In this work, we extended an existing 1D hemodynamics model including the characteristics of the anterior, middle and posterior cerebral artery. Furthermore, seven ipsilateral anastomoses were additionally integrated for each hemisphere. A potential stenosis was placed into the M1 segment of the middle cerebral artery, due to the highest risk of occlusion there. The extended model was evaluated for various degrees of collateralization (“poor”, “partial” and “good”) and degrees of stenosis (0%, 50%, 75% and 99.9%). Moreover, cerebral autoregulation was considered in the model. The higher the degree of collateralization and the degree of stenosis, the higher was the blood flow through the collaterals. Hence, a patient with a good collateralization could compensate a higher degree of occlusion and potentially has a better outcome after an ischemic stroke. For a 99.9% stenosis, an increased summed mean blood flow through the collaterals of +97.7% was predicted in case of good collateralization. Consequently, the blood supply via the terminal branches of the middle cerebral artery could be compensated up to 44.4% to the physiological blood flow. In combination with a temperature model, our model of the cerebral collateral circulation can be used for tailored temperature prediction for patients to be treated with selective therapeutic hypothermia. |
| first_indexed | 2024-04-11T08:18:30Z |
| format | Article |
| id | doaj.art-bc35b65e50a04cc6820efff24839ac18 |
| institution | Directory Open Access Journal |
| issn | 2364-5504 |
| language | English |
| last_indexed | 2024-04-11T08:18:30Z |
| publishDate | 2019-09-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Current Directions in Biomedical Engineering |
| spelling | doaj.art-bc35b65e50a04cc6820efff24839ac182022-12-22T04:35:04ZengDe GruyterCurrent Directions in Biomedical Engineering2364-55042019-09-015153353610.1515/cdbme-2019-0134cdbme-2019-0134Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic StrokeKrames Lorena0Daschner Rosa1Lutz Yannick2Loewe Axel3Dössel Olaf4Cattaneo Giorgio5Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT),Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT),Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT),Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT),Karlsruhe, GermanyInstitute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT),Karlsruhe, GermanyAdceris GmbH & Co KG,Pforzheim, GermanyStroke is the third-most cause of death in developed countries. A new promising treatment method in case of an ischemic stroke is selective intracarotid blood cooling combined with mechanical artery recanalization. However, the control of the treatment requires invasive or MRI-assisted measurement of cerebral temperature. An auspicious alternative is the use of computational modeling. In this work, we extended an existing 1D hemodynamics model including the characteristics of the anterior, middle and posterior cerebral artery. Furthermore, seven ipsilateral anastomoses were additionally integrated for each hemisphere. A potential stenosis was placed into the M1 segment of the middle cerebral artery, due to the highest risk of occlusion there. The extended model was evaluated for various degrees of collateralization (“poor”, “partial” and “good”) and degrees of stenosis (0%, 50%, 75% and 99.9%). Moreover, cerebral autoregulation was considered in the model. The higher the degree of collateralization and the degree of stenosis, the higher was the blood flow through the collaterals. Hence, a patient with a good collateralization could compensate a higher degree of occlusion and potentially has a better outcome after an ischemic stroke. For a 99.9% stenosis, an increased summed mean blood flow through the collaterals of +97.7% was predicted in case of good collateralization. Consequently, the blood supply via the terminal branches of the middle cerebral artery could be compensated up to 44.4% to the physiological blood flow. In combination with a temperature model, our model of the cerebral collateral circulation can be used for tailored temperature prediction for patients to be treated with selective therapeutic hypothermia.https://doi.org/10.1515/cdbme-2019-0134ischemic strokecerebral circulationipsilateral collateralsm1 stenosishemodynamics model |
| spellingShingle | Krames Lorena Daschner Rosa Lutz Yannick Loewe Axel Dössel Olaf Cattaneo Giorgio Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke Current Directions in Biomedical Engineering ischemic stroke cerebral circulation ipsilateral collaterals m1 stenosis hemodynamics model |
| title | Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke |
| title_full | Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke |
| title_fullStr | Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke |
| title_full_unstemmed | Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke |
| title_short | Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke |
| title_sort | modeling of the human cerebral collateral circulation evaluation of the impact on the cerebral perfusion in case of ischemic stroke |
| topic | ischemic stroke cerebral circulation ipsilateral collaterals m1 stenosis hemodynamics model |
| url | https://doi.org/10.1515/cdbme-2019-0134 |
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