[Experimental simulation study on hemodynamics in multiple cerebral arterial stenoses and EC-IC bypass].

Area of Science:

• Biomedical Engineering
• Cardiovascular Hemodynamics
• Medical Device Simulation

Context:

• Increasing incidence of unilateral or bilateral multiple stenoses in the internal carotid artery (ICA).
• Complexity in analyzing ICA hemodynamics due to variable lesion characteristics and collateral circulation.
• Need for effective methods to understand and predict hemodynamic changes after surgical interventions.

Purpose:

• To develop and utilize a hydraulic vascular model of the internal carotid artery to simulate hemodynamic changes.
• To independently manage factors like stenosis number, size, and location within the model.
• To analyze the impact of different stenosis configurations on blood flow dynamics.

Summary:

• A silicone and glass hydraulic model of the ICA was created, with peripheral resistance adjusted for realistic flow (180 ml/min at 60 mmHg).
• Four stenosis types (Ra, Rb, Rc, Rd) were used to simulate various multiple stenosis scenarios.
• Findings indicate that in serial stenoses, the most proximal lesion has a dominant effect on flow reduction; multiple stenoses require clearing of all lesions to significantly increase flow.

Impact:

• Provides insights into the hemodynamic significance of lesion order in multiple internal carotid artery stenoses.
• Suggests that targeted surgical intervention on the most severe, proximal stenosis may be most effective for flow restoration.
• Highlights the utility of hydraulic vascular models for pre-operative simulation and understanding complex cerebrovascular conditions.