NDLI: Investigation of cerebral hemodynamics and collateralization in asymptomatic carotid stenoses

Content Provider	IEEE Xplore Digital Library
Author	AlMuhanna, K. Limin Zhao Kowalewski, G. Beach, K.W. Lal, B.K. Sikdar, S.
Copyright Year	2012
Description	Author affiliation: Electr. & Comput. Eng. Dept., George Mason Univ., Fairfax, VA, USA (AlMuhanna, K.; Sikdar, S.) \|\| Univ. of Maryland Med. Center, Baltimore, MD, USA (Limin Zhao) \|\| Baltimore Veteran Affairs Med. Center, Baltimore, MD, USA (Kowalewski, G.) \|\| Dept. of Surg., Univ. of Washington, Seattle, WA, USA (Beach, K.W.) \|\| Dept. of Vascular Surg., Univ. of Maryland, Baltimore, MD, USA (Lal, B.K.)
Abstract	Stroke is the second leading cause of death in the world, and one of the major causes of disability. Approximately 30% of ischemic strokes are due to plaque rupture in the carotid arteries. The most popular diagnostic method uses Doppler ultrasound to find the percent stenosis. However, other factors, such as the hemodynamics around the plaque may play a larger role in identifying the risk of plaque rupture. It has been shown previously in simulations that non-collateral flow in the circle of Willis (COW) could cause an increase of the intraluminal velocity around carotid plaque. This added strain may increase the vulnerability of the plaque to rupture. We investigated asymmetries in flow waveforms in the middle cerebral artery (MCA) in asymptomatic patients with carotid artery stenosis. We compared clinical results of velocity waveforms in the MCA, acquired using transcranial Doppler (TCD), with a simple linear simulation model of the intra- and extracranial arterial network to investigate the relationship between contralateral and ipsilateral flow profiles in the MCA for patients with asymptomatic carotid stenosis. In 17 out of 23 patients we found waveforms consistent with those predicted for a collateralized COW, with minimal differences in delay, velocity magnitude and resistivity index. In 6 cases, some unexpected findings were noted, such as large delays for 2 patients ≤ 50% stenosis, and a large velocity difference with low delay for 4 patients. More studies are needed to elucidate the role of incomplete intracranial collateralization on the hemodynamics around carotid plaque and to use imaging of the COW to corroborate our results.
Sponsorship	IEEE Eng. Medicine Biol. Soc.
Starting Page	5618
Ending Page	5621
File Size	581303
Page Count	4
File Format	PDF
ISBN	9781424441198
ISSN	1557170X
e-ISBN	9781457717871
DOI	10.1109/EMBC.2012.6347268
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2012-08-28
Publisher Place	USA
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Delay Carotid arteries Integrated circuit modeling Hemodynamics Doppler effect Velocity measurement
Content Type	Text
Resource Type	Article
Subject	Signal Processing Biomedical Engineering Health Informatics Computer Vision and Pattern Recognition

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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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