Hemodynamic Differences Between Basilar Artery Fenestration and Normal Vertebrobasilar Artery: A Pilot Study

Area of Science:

• Neuroscience
• Medical Imaging
• Biophysics

Background:

• Basilar artery fenestration (BAF) is a rare anatomical variation.
• Unique flow patterns in BAF may predispose individuals to ischemic stroke.
• Understanding BAF hemodynamics is crucial for stroke risk assessment.

Purpose of the Study:

• To evaluate the hemodynamic characteristics of basilar artery fenestration (BAF) using computational fluid dynamics (CFD).
• To compare hemodynamic parameters between patients with BAF and a control group with normal vertebrobasilar systems.

Main Methods:

• Geometric vascular models were reconstructed from 3D-rotational angiography (3D-RA).
• Computational fluid dynamics (CFD) simulations were performed on BAF and control patient models.
• Hemodynamic variables including OSI and TAWSSG were calculated and compared between groups.

Main Results:

• The BAF group exhibited a significantly smaller basilar artery diameter compared to controls.
• Higher maxOSI and TAWSSG values were observed in the BAF group at flow confluence and bifurcation.
• Elevated SAR-TAWSSG in the basilar artery of the BAF group indicated disturbed flow patterns.

Conclusions:

• Significant hemodynamic differences exist between basilar artery fenestration and normal vertebrobasilar arteries.
• Disturbed flow patterns in BAF may elevate the risk of thrombus formation and plaque instability.
• Further research is warranted to confirm the association between BAF hemodynamics and ischemic cerebrovascular events.