CT-derived fractional flow reserve in intracranial arterial stenosis: A pilot study based on computational fluid dynamics

Yin, Zhuhao; Zhou, Changsheng; Guo, Jian; Wei, Yuan; Ma, Yifei; Zhou, Fan; Zhu, Wusheng; Zhang, Long Jiang

doi:10.1016/j.ejrad.2024.111285

Cited by 1 publication

(1 citation statement)

References 28 publications

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“…19 Yin et al found a significantly lower PR in patients with sICAS with apparent hypoperfusion than those with normal perfusion defined in 4D CTA (means 0.38 vs 0.76, p<0.01), although the sample size was small for the analysis (n=10). 10 In addition, Raynald et al observed a good agreement on the blood flow rate derived from CFD modelling and TCD measurements (mean difference: −0.78 mL/s, p for Bland-Altman test=0.027), while the mean velocities showed less agreement between CFD simulation and TCD measurements (mean difference: −0.05 cm/s, p for Bland-Altman test=0.399), which indicated greatly varied flow resistance among individuals. 12 Overall, these studies have revealed the role of translesional pressure gradient across sICAS lesions in affecting the distal collateral and perfusion status, while various factors could affect these relationships.…”

Section: Correlations With Collateral and Perfusion Status In Crossse...mentioning

confidence: 97%

Clinical implications of haemodynamics in symptomatic intracranial atherosclerotic stenosis by computational fluid dynamics modelling: a systematic review

Liu,

Li,

Liu

et al. 2024

Stroke Vasc Neurol

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BackgroundRecently, computational fluid dynamics (CFD) has been used to simulate blood flow of symptomatic intracranial atherosclerotic stenosis (sICAS) and investigate the clinical implications of its haemodynamic features, which were systematically reviewed in this study.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology statements, we searched PubMed and Embase up to March 2024 and screened for articles reporting clinical implications of haemodynamic parameters in sICAS derived from CFD models.Results19 articles met the inclusion criteria, all studies recruiting patients from China. Most studies used CT angiography (CTA) as the source image for vessel segmentation, and generic boundary conditions, rigid vessel wall and Newtonian fluid assumptions for CFD modelling, in patients with 50%-99% sICAS. Pressure and wall shear stress (WSS) were quantified in almost all studies, and the translesional changes in pressure and WSS were usually quantified with a poststenotic to prestenotic pressure ratio (PR) and stenotic-throat to prestenotic WSS ratio (WSSR). Lower PR was associated with more severe stenosis, better leptomeningeal collaterals, prolonged perfusion time and internal borderzone infarcts. Higher WSSR and other WSS measures were associated with positive vessel wall remodelling, regression of luminal stenosis and artery-to-artery embolism. Lower PR and higher WSSR were both associated with the presence and severity of cerebral small vessel disease. Moreover, translesional PR and WSSR were promising predictors for stroke recurrence in medically treated patients with sICAS and outcomes after acute reperfusion therapy, which also provided indicators to assess the effects of stenting treatment on focal haemodynamics.ConclusionsCFD is a promising tool in investigating the pathophysiology of ICAS and in risk stratification of patients with sICAS. Future studies are warranted for standardisation of the modelling methods and validation of the simulation results in sICAS, for its wider applications in clinical research and practice.

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Section: Correlations With Collateral and Perfusion Status In Crossse...mentioning

confidence: 97%

Clinical implications of haemodynamics in symptomatic intracranial atherosclerotic stenosis by computational fluid dynamics modelling: a systematic review

Liu,

Li,

Liu

et al. 2024

Stroke Vasc Neurol

View full text Add to dashboard Cite

show abstract

CT-derived fractional flow reserve in intracranial arterial stenosis: A pilot study based on computational fluid dynamics

Cited by 1 publication

References 28 publications

Clinical implications of haemodynamics in symptomatic intracranial atherosclerotic stenosis by computational fluid dynamics modelling: a systematic review

Clinical implications of haemodynamics in symptomatic intracranial atherosclerotic stenosis by computational fluid dynamics modelling: a systematic review

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