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The Role Of Circle Of Willis Anatomy Variations In Cardio-embolic Stroke - A Patient-specific Simulation Based Study

View ORCID ProfileDebanjan Mukherjee, Neel D. Jani, Jared Narvid, Shawn C. Shadden
doi: https://doi.org/10.1101/190579
Debanjan Mukherjee
1Dept. of Mechanical Engineering, University of California, Berkeley
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Neel D. Jani
1Dept. of Mechanical Engineering, University of California, Berkeley
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Jared Narvid
2Radiology and Biomedical Imaging, University of California, San Francisco
3Zuckerberg San Francisco General Hospital and Trauma Center
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Shawn C. Shadden
1Dept. of Mechanical Engineering, University of California, Berkeley
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Abstract

We describe a patient-specific simulation based investigation on the role of Circle of Willis anatomy in cardioembolic stroke. Our simulation framework consists of medical image-driven modeling of patient anatomy including the Circle, 3D blood flow simulation through patient vasculature, embolus transport modeling using a discrete particle dynamics technique, and a sampling based approach to incorporate parametric variations. A total of 24 (four patients and six Circle anatomies including the complete Circle) models were considered, with cardiogenic emboli of varying sizes and compositions released virtually and tracked to compute distribution to the brain. The results establish that Circle anatomical variations significantly influence embolus distribution to the six major cerebral arteries. Embolus distribution to MCA territory is found to be least sensitive to the influence of anatomical variations. For varying Circle topologies, differences in flow through cervical vasculature are observed. This incoming flow is recruited differently across the communicating arteries of the Circle for varying anastomoses. Emboli interact with the routed flow, and can undergo significant traversal across the Circle arterial segments, depending upon their inertia and density ratio with respect to blood. This interaction drives the underlying biomechanics of embolus transport across the Circle, explaining how Circle anatomy influences embolism risk.

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Posted April 12, 2018.
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The Role Of Circle Of Willis Anatomy Variations In Cardio-embolic Stroke - A Patient-specific Simulation Based Study
Debanjan Mukherjee, Neel D. Jani, Jared Narvid, Shawn C. Shadden
bioRxiv 190579; doi: https://doi.org/10.1101/190579
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The Role Of Circle Of Willis Anatomy Variations In Cardio-embolic Stroke - A Patient-specific Simulation Based Study
Debanjan Mukherjee, Neel D. Jani, Jared Narvid, Shawn C. Shadden
bioRxiv 190579; doi: https://doi.org/10.1101/190579

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