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Modelling collateral flow and thrombus permeability during acute ischaemic stroke.

Raymond M Padmos1,2, Nerea Arrarte Terreros3,4, Tamás I Józsa5,6

  • 1Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098, The Netherlands.

Journal of the Royal Society, Interface
|October 4, 2022
PubMed
Summary

Good collateral circulation significantly impacts outcomes in acute ischemic stroke, more than thrombus permeability. Our study highlights collaterals as the primary factor influencing stroke-related infarct volume.

Keywords:
acute ischaemic strokeblood flow modellingcollateral flowinfarct volumethrombus permeability

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Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Computational Biology

Background:

  • Good functional outcomes after acute ischemic stroke correlate with collateral circulation and high thrombus permeability.
  • Understanding the interplay between these factors is crucial for predicting stroke progression.

Purpose of the Study:

  • To investigate the combined influence of collateral circulation and thrombus permeability on cerebral blood flow during acute ischemic stroke.
  • To determine the dominant factor affecting infarct volume in stroke patients.

Main Methods:

  • A computational model simulating cerebral blood flow, incorporating leptomeningeal collateral circulation.
  • Varying collateral circulation to represent scores from absent to good.
  • Estimating thrombus permeability using patient data on transit time, void fraction, and thrombus length.

Main Results:

  • Simulations showed that flow rates through the thrombus were minimal.
  • The impact of thrombus permeability on brain perfusion was less significant than that of collateral circulation.
  • Collateral circulation emerged as the dominant factor influencing infarct volume.

Conclusions:

  • Cerebral blood flow modeling reveals collateral circulation as the primary determinant of infarct size in acute ischemic stroke.
  • Thrombus permeability plays a minor role compared to the effect of collaterals on brain perfusion during stroke.