Understanding Thromboembolus Transport Patterns In The Brain For Stroke In The Presence Of Carotid Artery Stenosis

Area of Science:

• Biomedical Engineering
• Neurology
• Cardiovascular Research

Background:

• Determining the origin of emboli is crucial for stroke treatment.
• Carotid stenosis is a primary cause of embolic strokes.
• Contralateral emboli transport complicates identifying the symptomatic carotid artery.

Purpose of the Study:

• To investigate the transport of thromboemboli from carotid artery stenosis.
• To analyze emboli behavior in patient-specific arterial models with varying stenosis degrees.
• To clarify the role of bilateral carotid stenosis in stroke etiology.

Main Methods:

• Utilized a computational embolus-hemodynamics interaction model.
• Simulated emboli transport in 30 patient-specific heart-to-brain arterial models.
• Varied combinations of bilateral severe and mild carotid stenosis degrees.

Main Results:

• Thromboemboli from both left and right carotid artery sources demonstrated contralateral transport.
• Cardiogenic thromboemboli showed no altered hemisphere distribution or transport preference based on stenosis.
• Contralateral carotid stenosis can cause emboli to cross the Circle of Willis.

Conclusions:

• Carotid stenosis can lead to contralateral emboli, creating diagnostic ambiguity.
• The degree of stenosis does not alter cardiogenic emboli distribution.
• Understanding contralateral transport is vital for accurate stroke diagnosis and treatment planning.