Open AccessMiddle cerebral artery pressure laterality in patients with symptomatic ICA stenosis
Author(s) -
Madelene Holmgren,
Karen-Helene Støverud,
Laleh Zarrinkoob,
Anders Wåhlin,
Jan Malm,
Anders Eklund
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0245337
Subject(s) - stenosis , internal carotid artery , laterality , medicine , middle cerebral artery , cardiology , cerebral perfusion pressure , hemodynamics , cerebral arteries , perfusion , radiology , ischemia , audiology
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 (ΔP MCA ) was related to the hemispheric flow laterality (ΔQ) 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 ΔP MCA was calculated from CFD, where patient-specific flow rates were applied at all input- and output boundaries. The ΔP MCA 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 ΔP MCA and ΔQ ICA (r = 0.85, p<0.001) and ΔQ ACA (r = 0.71, p<0.001), respectively. The correlation to ΔQ MCA 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.