Collateral flow and pulsatility during large vessel occlusions: insights from a quantitative in vitro study

Frontiers in Bioengineering and Biotechnology, vol. 12, pp. 1421714

Abstract

data on pathological collateral flow during large vessel occlusions are not available. Moreover, there are no flow models that accurately simulate the hemodynamic conditions in the CoW during large vessel occlusions. We used a circulatory loop to generate highly reproducible cerebrovascular-like flows and pressures and used non-invasive flow visualization and high-resolution flow and pressure measurements to acquire detailed, time-dependent hemodynamics inside an anatomical phantom of the CoW. After calibrating a physiological reference case, we induced occlusions in the 1. middle cerebral artery, 2. terminal carotid artery, and 3. basilar artery; and measured the left posterior communicating artery flow. Mean arterial pressure and pulse pressure remained unchanged in the different occlusion cases compared to the physiological reference case, while total cerebral flow decreased by up to 19%. In all three occlusion cases, reversed flow was found in the left posterior communicating artery compared to the reference case with different flow magnitudes and pulsatility index values. The experimental results were compared with clinical findings, demonstrating the capability of this realistic cerebrovascular flow setup. This novel cerebrovascular flow setup opens the possibility for investigating different topics of neurovascular interventions under various clinical conditions in controlled preclinical laboratory studies.

Authors 5

1. Claudio A. Luisi Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany

2. Omid Nikoubashman Aachen Clinic for Diagnostic and Interventional Neuroradiology Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Clinic for Diagnostic and Interventional Neuroradiology, Medical Faculty, RWTH Aachen University, Aachen, Germany

3. Ulrich Steinseifer Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany

4. Martin Wiesmann Aachen Clinic for Diagnostic and Interventional Neuroradiology Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Clinic for Diagnostic and Interventional Neuroradiology, Medical Faculty, RWTH Aachen University, Aachen, Germany

5. Michael Neidlin corresponding Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany