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Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study
BACKGROUND: Cerebrovascular events are frequently associated with hemodynamic disturbance caused by internal carotid artery (ICA) stenosis. It is challenging to determine the ischemia-related carotid stenosis during the intervention only using digital subtracted angiography (DSA). Inspired by the pe...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848462/ https://www.ncbi.nlm.nih.gov/pubmed/29530025 http://dx.doi.org/10.1186/s12938-018-0465-9 |
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author | Zhang, Dong Xu, Pengcheng Qiao, Hongyu Liu, Xin Luo, Liangping Huang, Wenhua Zhang, Heye Shi, Changzheng |
author_facet | Zhang, Dong Xu, Pengcheng Qiao, Hongyu Liu, Xin Luo, Liangping Huang, Wenhua Zhang, Heye Shi, Changzheng |
author_sort | Zhang, Dong |
collection | PubMed |
description | BACKGROUND: Cerebrovascular events are frequently associated with hemodynamic disturbance caused by internal carotid artery (ICA) stenosis. It is challenging to determine the ischemia-related carotid stenosis during the intervention only using digital subtracted angiography (DSA). Inspired by the performance of well-established FFRct technique in hemodynamic assessment of significant coronary stenosis, we introduced a pressure-based carotid arterial functional assessment (CAFA) index generated from computational fluid dynamic (CFD) simulation in DSA data, and investigated its feasibility in the assessment of hemodynamic disturbance preliminarily using pressure-wired measurement and arterial spin labeling (ASL) MRI as references. METHODS: The cerebral multi-delay multi-parametric ASL-MRI and carotid DSA including trans-stenotic pressure-wired measurement were implemented on a 65-year-old man with asymptomatic unilateral (left) ICA stenosis. A CFD simulation using simplified boundary condition was performed in DSA data to calculate the CAFA index. The cerebral blood flow (CBF) and arterial transit time (ATT) of ICA territories were acquired. RESULTS: CFD simulation showed good correlation (r = 0.839, P = 0.001) with slight systematic overestimation (mean difference − 0.007, standard deviation 0.017) compared with pressure-wired measurement. No significant difference was observed between them (P = 0.09). Though the narrowing degree of in the involved ICA was about 70%, the simulated and measured CAFA (0.942/0.937) revealed a functionally nonsignificant stenosis which was also verified by a compensatory final CBF (fronto-temporal/fronto-parietal region: 51.58/45.62 ml/100 g/min) and slightly prolonged ATT (1.23/1.4 s) in the involved territories, together with a normal left–right percentage difference (2.1–8.85%). CONCLUSIONS: The DSA based CFD simulation showed good consistence with invasive approach and could be used as a cost-saving and efficient way to study the relationship between hemodynamic disorder caused by ICA stenosis and subsequent perfusion variations in brain. Further research should focus on the role of noninvasive pressure-based CAFA in screening asymptomatic ischemia-causing carotid stenosis. |
format | Online Article Text |
id | pubmed-5848462 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58484622018-03-21 Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study Zhang, Dong Xu, Pengcheng Qiao, Hongyu Liu, Xin Luo, Liangping Huang, Wenhua Zhang, Heye Shi, Changzheng Biomed Eng Online Research BACKGROUND: Cerebrovascular events are frequently associated with hemodynamic disturbance caused by internal carotid artery (ICA) stenosis. It is challenging to determine the ischemia-related carotid stenosis during the intervention only using digital subtracted angiography (DSA). Inspired by the performance of well-established FFRct technique in hemodynamic assessment of significant coronary stenosis, we introduced a pressure-based carotid arterial functional assessment (CAFA) index generated from computational fluid dynamic (CFD) simulation in DSA data, and investigated its feasibility in the assessment of hemodynamic disturbance preliminarily using pressure-wired measurement and arterial spin labeling (ASL) MRI as references. METHODS: The cerebral multi-delay multi-parametric ASL-MRI and carotid DSA including trans-stenotic pressure-wired measurement were implemented on a 65-year-old man with asymptomatic unilateral (left) ICA stenosis. A CFD simulation using simplified boundary condition was performed in DSA data to calculate the CAFA index. The cerebral blood flow (CBF) and arterial transit time (ATT) of ICA territories were acquired. RESULTS: CFD simulation showed good correlation (r = 0.839, P = 0.001) with slight systematic overestimation (mean difference − 0.007, standard deviation 0.017) compared with pressure-wired measurement. No significant difference was observed between them (P = 0.09). Though the narrowing degree of in the involved ICA was about 70%, the simulated and measured CAFA (0.942/0.937) revealed a functionally nonsignificant stenosis which was also verified by a compensatory final CBF (fronto-temporal/fronto-parietal region: 51.58/45.62 ml/100 g/min) and slightly prolonged ATT (1.23/1.4 s) in the involved territories, together with a normal left–right percentage difference (2.1–8.85%). CONCLUSIONS: The DSA based CFD simulation showed good consistence with invasive approach and could be used as a cost-saving and efficient way to study the relationship between hemodynamic disorder caused by ICA stenosis and subsequent perfusion variations in brain. Further research should focus on the role of noninvasive pressure-based CAFA in screening asymptomatic ischemia-causing carotid stenosis. BioMed Central 2018-03-12 /pmc/articles/PMC5848462/ /pubmed/29530025 http://dx.doi.org/10.1186/s12938-018-0465-9 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Zhang, Dong Xu, Pengcheng Qiao, Hongyu Liu, Xin Luo, Liangping Huang, Wenhua Zhang, Heye Shi, Changzheng Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
title | Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
title_full | Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
title_fullStr | Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
title_full_unstemmed | Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
title_short | Carotid DSA based CFD simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
title_sort | carotid dsa based cfd simulation in assessing the patient with asymptomatic carotid stenosis: a preliminary study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848462/ https://www.ncbi.nlm.nih.gov/pubmed/29530025 http://dx.doi.org/10.1186/s12938-018-0465-9 |
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