Pulsatile Hemodynamics and Carotid Stenting

描述(由申请人提供)： 对供应大脑的大传导血管进行血管成形术和支架植入是一种相对较新的治疗方法，可能是颈动脉内膜切除术的一种可行的替代方案。根据冠状动脉支架置入术的广泛历史，可以推测再狭窄将是限制颈动脉支架置入术长期成功的关键因素。影响再狭窄的血流动力学因素，特别是脉动压力和血流，几乎没有得到详细的研究。 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)测量颈动脉支架置入后再狭窄的程度及相关的搏动性血压和血流的变化；2)使用特定患者的计算模型预测支架置入后搏动性压力和流量的短期和长期变化；3)比较高和低搏动性水平下兔髂动脉的再狭窄；4)比较高和低搏动性水平下慢性支架置入血管的重构因素。 奎克博士是一名工程师，在血管床中脉动血流动力学的计算建模方面拥有丰富的背景。为奎克博士过渡到定量血管生物学职业生涯的为期五年的培训期寻求资金。这个研究血流动力学和血管生物学相互作用的项目，是DR的一个全新方向。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后，他现在可以专注于振荡压力和流量对血管机械特性的影响。这个项目代表着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.