Pulsatile Hemodynamics and Carotid Stenting

描述（由申请人提供）： 血管成形术和支架的大传导血管，供应大脑是一个相对较新的治疗，可能是一个可行的替代颈动脉内膜切除术。基于冠状动脉支架植入术的广泛历史，可以推测再狭窄将是限制颈动脉支架植入术长期成功的关键因素。影响再狭窄的血流动力学因素，特别是脉动压力和流量，很少受到审查。 我们假设支架内再狭窄的程度与压力和血流的脉动性有关。以下四个具体目标将解决这一假设：1）测量颈动脉支架植入术后的再狭窄程度以及脉动血压和流量的相关变化; 2）使用患者特定的计算模型预测支架植入术后脉动压力和流量的短期和长期变化; 3）比较高、低脉动压力和流量下兔髂动脉再狭窄的情况; 4）比较长期植入支架的血管在高水平和低水平脉动下的重塑因素。 博士Quick是一名工程师，在血管床脉动血流动力学的计算建模方面具有广泛的背景。为Quick博士过渡到定量血管生物学的职业生涯寻求五年培训期的资金。这个项目，解决血液动力学和血管生物学的相互作用，是一个从根本上新的方向博士。快速，但补充了他的专业知识。在研究了血管机械特性对振荡血压和血流的影响之后，他现在可以专注于振荡压力和血流对血管机械特性的影响。该项目代表了从研究血管重塑现象的理论工具到研究重塑机制的实验工具的自然进展。

DESCRIPTION (provided by applicant): Angioplasty and stenting of the large conductance vessels that supply the brain is a relatively new treatment that may be a viable alternative to carotid endarterectomy. Based on the extensive history of coronary artery stenting, it can be surmised that restenosis will be a key factor limiting the long-term success of carotid arterial stenting. The hemodynamic factors that influence restenosis, especially pulsatile pressure and flow, have received little scrutiny. We hypothesize that the degree of in-stent restenosis is related to pulsatility of pressure and flow. The following four specific aims will address this hypothesis: 1) To measure the degree of restenosis after carotid artery stenting and associated changes in pulsatile blood pressure and flow; 2) To predict with a patient-specific computational model the short and long-term changes in pulsatile pressure and flow after stenting; 3) To compare restenosis in rabbit iliac arteries that are subjected to high and low levels of pulsatile pressure and flow; 4) To compare remodeling factors in chronically stented vessels subjected to high and low levels of pulsatility. Dr. Quick is an engineer who has an extensive background in computational modeling of pulsatile hemodynamics in vascular beds. Funding is sought for a five-year training periodfor Dr. Quick to transition to a career in quantitative vascular biology. This project, addressing the interaction of hemodynamics and vascular biology, is a fundamentally new direction forDr. Quick, yet complements his expertise. Having studied the effect of vascular mechanical properties on oscillatory blood pressure and flow, he can now focus on the effect of oscillatory pressure and flow on vascular mechanical properties. This project represents a natural progression from theoretical tools to study the phenomena of vascular remodeling to the experimental tools to study the mechanisms of remodeling.