Hemodynamics in the Circle of Willis with Internal Carotid Artery Stenosis under Cervical Rotatory Manipulation: A Finite Element Analysis
Hemodynamics in the Circle of Willis with Internal Carotid Artery Stenosis under Cervical Rotatory Manipulation: A Finite Element Analysis
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颈内动脉狭窄颈椎旋转操作下 Willis 环的血流动力学：有限元分析
DOI：
10.12659/msm.892822
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发表时间：
2015-06-23
影响因子：
3.1
通讯作者：
Li, Yikai
中科院分区：
文献类型：
--
作者：
Lin, Weishen;Ma, Xiaokang;Li, Yikai
背景：Willis环(COW)在脑侧支循环中起重要作用。奶牛的血流动力学改变通常与颈内动脉(ICA)狭窄有关，但旋转手法是否会对其产生影响尚不清楚。材料/方法在本研究中，我们试图通过有限元分析的方法分析旋转手法对颈内动脉狭窄和非颈内动脉狭窄模型奶牛血流动力学的影响。为此，利用MIMICS10.0和ANSYS14.5对COW进行了合理简化，建立了流固耦合三维有限元模型。模拟健康人(无狭窄)和患病者(狭窄率分别为15%、30%、45%、60%、70%、80%和90%)的情况。在颈内动脉远端(此处选择右侧颈内动脉)施加60°的远位移位来模拟旋转手法。然后监测前交通动脉(ACoA)和后交通动脉(PCoA)的血流。结果旋转手法实施前，只有狭窄程度大于70%的模型才有明显的血流变化，应用远位移位后，除狭窄程度为90%的模型外，其余情况无显著差异。结论当颈内动脉狭窄程度小于90%时，旋转手法对奶牛血流无明显影响，在大多数临床应用中是一种安全的手法。
Background The circle of Willis (CoW) plays an important role in cerebral collateral circulation. The hemodynamics changes in the CoW have usually been associated with the internal carotid artery (ICA) stenosis, but whether rotatory manipulation will affect it remains unknown. Material/Methods In this study we attempted to analyze the influence of rotatory manipulation on the hemodynamics in the CoW in models with or without ICA stenosis by means of finite element analysis. For this purpose, the CoW was reasonably simplified and a fluid-solid coupling 3D finite element model was created by using MIMICS10.0 and ANSYS14.5. The healthy (without stenosis) and the diseased (ratios of stenosis include 15%, 30%, 45%, 60%, 70%, 80%, and 90%) situations were simulated. A remote displacement of 60° was applied at a distal ICA (the right ICA was chosen here) to imitate the rotatory manipulation. Blood flow was then monitored at the anterior communicating artery (ACoA) and posterior communicating arteries (PCoA). Results Before the conduction of rotatory manipulation, blood flow changed significantly only when the stenosis ratio was increased to more than 70%, and the situation did not have significant difference after the application of remote displacement except the model with stenosis ration of 90%. Conclusions The result suggests that the rotatory manipulation does not have an obvious influence on the blood flow in the CoW when the stenosis of ICA is less than 90%, and this kind of manipulation is suggested to be a safe technique in most of the clinical applications.