Impact Of Systolic Blood Pressure On Cerebral Hemoynamics Measure By Computational Fluid Dynamics In Patients With Intracranial Atherosclerosis

Background: Success in clinical trials of intracranial atherosclerosis (ICAS) hinges upon the definition of high-risk patients. Noninvasive computational fluid dynamics (CFD) of stenotic lesions may enhance therapeutic decision-making, yet the wide hemodynamic variation may limit the snapshot data of CFD. We determined whether different physiologic parameters may change downstream cerebral hemodynamics in patients with ICAS. Methods: Based on degree of stenosis, patients were divided into a moderate (50-69%) and severe group (70-99%). CFD models were made using CTA source images of patients with symptomatic middle cerebral artery stenosis. Inlet boundary conditions were defined using three ranges (2.5, 50, and 97.5 percentiles) of systolic BP (109.2, 158, and 225 mmHg) and hematocrit (27.3, 40.2, and 48.8). According to systolic BP and hematocrit, 9 distinct scenarios were simulated. Ratio of pressure was calculated using the simulated pressure at pre- and post-stenotic segments. Ratio of shear strain rat...