Modelling the leptomeningeal collateral circulation during acute ischaemic stroke

Raymond M Padmos; Nerea Arrarte Terreros; Tamás I Józsa; Gábor Závodszky; Henk A Marquering; Charles B L M Majoie; Alfons G Hoekstra

doi:10.1016/j.medengphy.2021.03.003

Modelling the leptomeningeal collateral circulation during acute ischaemic stroke

Med Eng Phys. 2021 May:91:1-11. doi: 10.1016/j.medengphy.2021.03.003. Epub 2021 Mar 17.

Authors

Raymond M Padmos¹, Nerea Arrarte Terreros², Tamás I Józsa³, Gábor Závodszky⁴, Henk A Marquering², Charles B L M Majoie⁵, Alfons G Hoekstra⁴

Affiliations

¹ Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands. Electronic address: r.m.padmos@uva.nl.
² Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, the Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, the Netherlands.
³ Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK.
⁴ Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands.
⁵ Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, the Netherlands.

PMID: 34074460
DOI: 10.1016/j.medengphy.2021.03.003

Abstract

A novel model of the leptomeningeal collateral circulation is created by combining data from multiple sources with statistical scaling laws. The extent of the collateral circulation is varied by defining a collateral vessel probability. Blood flow and pressure are simulated using a one-dimensional steady state blood flow model. The leptomeningeal collateral vessels provide significant flow during a stroke. The pressure drop over an occlusion predicted by the model ranges between 60 and 85 mmHg depending on the extent of the collateral circulation. The linear transport of contrast material was simulated in the circulatory network. The time delay of peak contrast over an occlusion is 3.3 s in the model, and 2.1 s (IQR 0.8-4.0 s) when measured in dynamic CTA data of acute ischaemic stroke patients. Modelling the leptomeningeal collateral circulation could lead to better estimates of infarct volume and patient outcome.

Keywords: 1D blood flow model; Acute ischaemic stroke; Cerebral contrast transport; Collateral flow simulation; Leptomeningeal collateral circulation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Ischemia* / complications
Cerebrovascular Circulation
Collateral Circulation
Humans
Ischemic Stroke*
Meninges / diagnostic imaging
Stroke*