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Updated: Jul 15, 2025
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Hemodynamics combined with inflammatory indicators exploring relationships between ischemic stroke and symptomatic
Xiao-Bing Wu1, Yi-Ao Liu1,2, Li-Xin Huang1,2,3
1Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510120, Guangdong, China.
Insights
High-resolution vessel wall imaging and hemodynamic analysis identified the wall shear stress ratio as an independent risk factor for symptomatic intracranial atherosclerotic stenosis, revealing combined hemodynamic and inflammatory roles in plaque progression.
Area of Science:
- Neurology
- Cardiovascular Research
- Medical Imaging
Background:
- Intracranial atherosclerotic stenosis (ICAS) is a leading cause of ischemic stroke.
- High-resolution vessel wall imaging (HR-VWI) allows detailed assessment of ICAS plaque characteristics.
Purpose of the Study:
- To investigate the combined roles of HR-VWI plaque characteristics, hemodynamics, and peripheral inflammatory indicators in symptomatic ICAS (sICAS).
- To explore the interrelationships between these factors in the development and progression of sICAS.
Main Methods:
- Retrospective analysis of 32 patients with middle cerebral artery stenosis using HR-VWI.
- Quantitative analysis of plaque enhancement (contrast ratio - CR) and computational fluid dynamics for hemodynamic parameters (wall shear stress - WSS, pressure ratio - PR).
- Statistical analyses including univariate, multivariable, and correlation analyses to identify predictors and interrelationships.
Main Results:
- Higher plaque enhancement and WSS ratio (WSSR) were significantly associated with sICAS.
- WSSR emerged as an independent risk factor for sICAS.
- Plaque enhancement and burden correlated positively with WSSR and negatively with the lymphocyte-to-monocyte ratio (LMR).
Conclusions:
- WSSR is a significant independent risk factor for sICAS.
- Plaque characteristics and inflammation markers are interrelated with hemodynamic factors.
- Combined hemodynamic forces and inflammation contribute to the progression of intracranial atherosclerotic plaques.
Background And Purpose:
Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke, and high-resolution vessel wall imaging (HR-VWI) can be used to assess the plaque characteristics of ICAS. This study combined HR-VWI, hemodynamics, and peripheral blood inflammatory indicators to investigate the role of these factors in symptomatic intracranial atherosclerotic stenosis (sICAS) and their inter-relationships.
Methods:
Patients diagnosed with atherosclerotic middle cerebral artery stenosis were recruited retrospectively from June 2018 to July 2022. Plaque enhancement was qualitatively and quantitatively analyzed, and the degree of plaque enhancement was graded according to the plaque-to-pituitary stalk contrast ratio (CR). Computational fluid dynamics models were constructed, and then hemodynamic parameters, including wall shear stress (WSS) and pressure ratio (PR), were measured and recorded. Univariate and multivariable analyses were performed to identify factors that can predict sICAS. In addition, the correlation analysis between the plaque characteristics on HR-VWI, hemodynamic parameters, and peripheral blood inflammatory indicators was performed to investigate the interrelationships between these factors.
Results:
Thirty-two patients were included. A higher proportion of plaque enhancement, maximum WSS, and WSS ratio (WSSR) were significantly associated with sICAS. The multiple logistic regression analysis showed that only the WSSR was an independent risk factor for sICAS. The correlation analysis revealed that both the CR and plaque burden showed linear positive correlation with the WSSR (R = 0.411, P = 0.022; R = 0.474, P = 0.007, respectively), and showed linear negative correlation with the lymphocyte to monocyte ratio (R = 0.382, P = 0.031; R = 0.716, P < 0.001, respectively).
Conclusions:
The plaque enhancement and WSSR were significantly associated with sICAS, WSSR was an independent risk factor for sICAS. Plaque enhancement and plaque burden showed linear correlation with the WSSR and lymphocyte-to-monocyte ratio (LMR). Hemodynamics and inflammation combined to promote plaque progression.
