Related Experiment Video
Updated: Aug 2, 2026
Utilizing a Cranial Window to Visualize the Middle Cerebral Artery During Endothelin-1 Induced Middle Cerebral Artery Occlusion
Published on: February 22, 2013
Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis
Danfeng Zhang1, Xinying Wu1, Jie Tang1
1Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China.
Insights
Positive remodeling in middle cerebral artery stenosis is linked to higher hemodynamic stress and increased stroke risk. Understanding these hemodynamic factors is crucial for predicting stroke development in patients with atherosclerotic plaques.
Area of Science:
- Neurology
- Cardiovascular Research
- Medical Imaging
Background:
- Atherosclerotic stenosis in the middle cerebral artery (MCA) is a significant cause of ischemic stroke.
- Vessel wall remodeling patterns, particularly positive remodeling (PR), are associated with plaque instability and stroke risk.
- The interplay between hemodynamics and vessel wall remodeling in MCA stenosis requires further investigation.
Purpose of the Study:
- To investigate the relationship between hemodynamic parameters and vessel wall remodeling patterns in patients with MCA stenosis.
- To determine if specific hemodynamic features are associated with positive or negative remodeling in MCA atherosclerotic plaques.
- To explore the correlation between hemodynamic indices and plaque characteristics, and their association with acute stroke events.
Main Methods:
- Prospective recruitment of 40 patients with MCA stenosis (50-99%) and recent ischemic events.
- High-resolution magnetic resonance imaging (MRI) for cross-sectional vessel wall assessment.
- Computational fluid dynamics (CFD) to derive hemodynamic parameters like translesional wall shear stress ratio (WSSR) and wall shear stress in stenosis (WSSs).
- Classification of patients into positive remodeling (PR), negative remodeling (NR), and non-remodeling groups based on vessel wall changes.
Main Results:
- The PR group exhibited smaller lumen area, larger plaque area, normal wall index, and higher WSSR and WSSs compared to the NR group.
- Positive remodeling was associated with more enhanced plaques and a higher incidence of acute stroke.
- Remodeling index and plaque area showed a positive correlation with WSSR, indicating a link between plaque burden, remodeling, and hemodynamic stress.
Conclusions:
- Hemodynamic forces significantly influence atherosclerotic plaque development and vessel wall remodeling in MCA stenosis.
- Patients with PR and elevated hemodynamic stress (higher WSSR) are at a greater risk of experiencing acute stroke.
- These findings highlight the potential of hemodynamic assessment in understanding the mechanisms of stroke in MCA stenosis and identifying high-risk individuals.
Objectives:
To evaluate the relationship between hemodynamics and vessel wall remodeling patterns in middle cerebral artery (MCA) stenosis based on high-resolution magnetic resonance imaging and computational fluid dynamics (CFD).
Methods:
Forty consecutive patients with recent ischemic stroke or transient ischemic attack attributed to unilateral atherosclerotic MCA stenosis (50-99%) were prospectively recruited. All patients underwent a cross-sectional scan of the stenotic MCA vessel wall. The parameters of the vessel wall, the number of patients with acute infarction, translesional wall shear stress ratio (WSSR), wall shear stress in stenosis (WSSs), and translesional pressure ratio were obtained. The patients were divided into positive remodeling (PR) and negative remodeling (NR) groups. The differences in vessel wall parameters and hemodynamics were compared. Correlations between the parameters of the vessel wall and hemodynamics were calculated.
Results:
Of the 40 patients, 16 had PR, 19 had NR, and the other 5 displayed non-remodeling. The PR group had a smaller lumen area (p = 0.004), larger plaque area (p < 0.001), normal wall index (p = 0.004), and higher WSSR (p = 0.004) and WSSs (p = 0.023) at the most narrowed site. The PR group had more enhanced plaques (12 vs 6, p = 0.03). The number of patients with acute stroke in the PR group was more than that in the NR group (11 vs 4, p = 0.01). The remodeling index (r = 0.376, p = 0.026) and plaque area (r = 0.407, p = 0.015) showed a positive correlation with WSSR, respectively.
Conclusions:
Hemodynamics plays a role in atherosclerotic plaques and vessel wall remodeling. Individuals with greater hemodynamic values might be more prone to stroke.
Key Points:
• Stenotic plaques in middle cerebral artery with positive remodeling have smaller lumen area and larger resp. higher plaque area, normal wall index, translesional wall shear stress ratio, and wall shear stress than negative remodeling. • The remodeling index and plaque area are positively correlated with translesional wall shear stress ratio. • Hemodynamic may help to understand the role of positive remodeling in the development of acute stroke.
More Related Videos
07:30In Vitro Model of Physiological and Pathological Blood Flow with Application to Investigations of Vascular Cell Remodeling
Published on: November 3, 2015
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
