Optimality principles and flow orderliness at the branching points of cerebral arteries.

Rossitti, Sandro; Löfgren, Jan

doi:10.1161/01.str.24.7.1029

Cited by 56 publications

(39 citation statements)

References 15 publications

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“…The studies by Rossitti and Lofgren 28,35 demonstrated that the branching angles of cerebral arteries may vary widely and that the apex of the bifurcation may lie in a nonoptimal position relative to the dividing streamline of the flow in the parent vessel, resulting in turbulence, vibrations, and increased shear stress on the vessel wall at the apical region, despite the fact that the blood flow/vessel radius relation is optimal. If aneurysm initiation or progression is related to the bifurcation angle at the vascular divider, then the balance of hemodynamic forces responsible likely will be altered by the stent-induced remodeling described in the current study.…”

Section: Discussionmentioning

confidence: 99%

Stent-Assisted Coiling of Intracranial Bifurcation Aneurysms Leads to Immediate and Delayed Intracranial Vascular Angle Remodeling

Gao¹,

Baharoglu²,

Cohen³

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Stent-Assisted Coiling of Intracranial Bifurcation Aneurysms Leads to Immediate and Delayed Intracranial Vascular Angle Remodeling

Gao¹,

Baharoglu²,

Cohen³

et al. 2011

AJNR Am J Neuroradiol

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“…76 Deviations or alterations from optimal architecture are speculated to result in impaired microcirculatory transport, reduced efficiency, and, thereby, a greater risk of vascular damage. [76][77][78] With innovative technology in retinal photography and computing image processing techniques, new computer-based programs were developed ( Figure S3B) to perform objective and quantitative assessment of novel classes of retinal geometrical and branching parameters, such as tortuosity, fractal dimension, branching angles, and vascular length:diameter ratio reliably and rapidly ( Figure S3C through S3E in the online-only Data Supplement). Examining the branching pattern of the retinal vasculature may indicate the optimal state of the retinal microcirculation and provide additional cardiovascular risk information to enable better predictive ability of cardiovascular outcomes.…”

Section: Advances In the Retinal Vascular Imaging Technologies Assessmentioning

confidence: 99%

Retinal Microvasculature as a Model to Study the Manifestations of Hypertension

Cheung

Ikram²,

Sabanayagam³

et al. 2012

Hypertension

224

166

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The retinal vasculature allows direct noninvasive visualization of the body’s mircrovasculature. Because the retina and other end organs (brain and kidney) share similar anatomical features and physiological properties, the retinal vessels offer a unique and easily accessible window to study the health and disease of the human microcirculation. Advanced retinal vascular imaging technologies have been developed to allow a more objective and precise assessment of retinal vascular changes. The changes in the retinal vasculature associated with hypertension can be broadly divided into 3 groups: (1) classic retinal vascular changes in response to blood pressure (referred to as hypertensive retinopathy signs), (2) changes in retinal vascular caliber, and (3) changes in more global geometrical patterns of the retina. In this review, we summarize the current understanding of the relationship between retinal vascular changes and blood pressure, the evidence for the retinal vasculature as a biological model to study the manifestation and early pathogenic correlates of hypertension, the latest advances in retinal vascular imaging technologies, and the future opportunities and challenges of retinal vascular imaging. We suggest that further development of retinal vascular analyses and standardized measurement protocols, evaluation of the clinical use of retinal vascular imaging in assessing cardiovascular risk prediction, and using retinal vascular imaging to test antihypertensive treatments will allow the translation of retinal vascular imaging as a tool to improve the diagnosis, prognosis, and management of hypertension in clinical practice.

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“…11 An optimal arrangement of branching and bifurcation sites in the cerebral vasculature is essential to preserve minimum energy expenditure along the network by maintaining constant wall shear stress (WSS) across daughter and parent vessels. 11,25 This vascular optimality principle has been shown to generally apply to the cerebral circulation 11,19,20 and implies a relative optimal bifurcation angle depending on the relative sizes of the daughter branches. Consequently, changes in vessel design at bifurcations are intrinsically linked to altered hemodynamic forces at the apex and, as such, to a possible increased risk of IA formation.…”

confidence: 99%

Widening of the basilar bifurcation angle: association with presence of intracranial aneurysm, age, and female sex

Tütüncü¹,

Schimansky²,

Baharoglu³

et al. 2014

JNS

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Object. Arterial bifurcations represent preferred locations for aneurysm formation, especially when they are associated with variations in divider geometry. The authors hypothesized a link between basilar apex aneurysms and basilar bifurcation (a) and vertebrobasilar junction (VBJ) angles.Methods. The a and VBJ angles were measured in 3D MR and rotational angiographic volumes using a coplanar 3-point technique. Angle a was compared between age-matched cohorts in 45 patients with basilar artery (BA) aneurysms, 65 patients with aneurysms in other locations (non-BA), and 103 nonaneurysmal controls. Additional analysis was performed in 273 nonaneurysmal controls. Computational fluid dynamics (CFD) simulations were performed on parametric BA models with increasing angles.Results. Angle a was significantly wider in patients with BA aneurysms (146.7° ± 20.5°) than in those with non-BA aneurysms (111.7° ± 18°) and in controls (103° ± 20.6°) (p < 0.0001), whereas no difference was observed for the VBJ angle. A wider angle a correlated with BA aneurysm neck width but not dome size, which is consistent with CFD results showing a widening of the impingement zone at the bifurcation apex. BA bifurcations hosting even small aneurysms (< 5 mm) had a significantly larger a angle compared with matched controls (p < 0.0001). In nonaneurysmal controls, a increased with age (p < 0.0001), with a threshold effect above 35 years of age and a steeper dependence in females (p = 0.002) than males (p = 0.04).Conclusions. The a angle widens with age during adulthood, especially in females. This angular widening is associated with basilar bifurcation aneurysms and may predispose individuals to aneurysm initiation by diffusing the flow impingement zone away from the protective medial band region of the flow divider. (http://thejns.org/doi/abs/10.3171/2014 key WorDS • vessel morphology • basilar bifurcation • vascular disorders • bifurcation aneurysms • vascular age dependencyAbbreviations used in this paper: AUC = area under the curve; BA = basilar artery; CFD = computational fluid dynamics; IA = intracranial aneurysm; MPR = multiplanar reconstruction; MRA = MR angiography; PCA = posterior cerebral artery; ROC = receiver operating characteristic; VBJ = vertebrobasilar junction; WSS = wall shear stress.

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Optimality principles and flow orderliness at the branching points of cerebral arteries.

Cited by 56 publications

References 15 publications

Stent-Assisted Coiling of Intracranial Bifurcation Aneurysms Leads to Immediate and Delayed Intracranial Vascular Angle Remodeling

Stent-Assisted Coiling of Intracranial Bifurcation Aneurysms Leads to Immediate and Delayed Intracranial Vascular Angle Remodeling

Retinal Microvasculature as a Model to Study the Manifestations of Hypertension

Widening of the basilar bifurcation angle: association with presence of intracranial aneurysm, age, and female sex

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