Computational analysis of hemodynamics using a two-dimensional model in moyamoya disease.
OBJECTIVE
Bilateral intimal thickening of the distal internal carotid arteries (ICAs) and the development of many collateral vessels in the base of the brain characterize moyamoya disease (MMD). Although the etiology of and the reason why MMD is limited to the major intracranial vessels remain unclear, flow dynamics, such as shear stress, may be related to its smooth-muscle cell migration. Therefore, this study was performed to determine the local hemodynamic factor, which concerns the predominance of specific anatomical sites, such as the distal ICA in the early stage and the proximal posterior cerebral artery (PCA) in the advanced stage of MMD.


METHODS
The authors simulated the hemodynamics in the circle of Willis using computational models of 2D geometries of the distal ICA and PCA. A finite-element commercial package, automatic dynamics incremental nonlinear analysis (ADINA), was used to simulate blood flow in these arteries.


RESULTS
Numerical results demonstrated that shear stress was relatively low at the ICA region. The distribution of shear stress was related to the predisposing area of MMD.


CONCLUSIONS
Diminished shear stress may promote stenosis of the distal ICA, which is a major pathological region in MMD.
Seol
Ho Jun
HJ
Department of Neurosurgery, Kangwon National University, Chuncheon, South Korea.
Shin
Duk Chul
DC
Kim
Yoo Seok
YS
Shim
Eun Bo
EB
Kim
Seung-Ki
SK
Cho
Byung-Kyu
BK
Wang
Kyu-Chang
KC
D001783:Blood Flow Velocity / Q000502:physiology; D002343:Carotid Artery, Internal / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology; D006801:Humans; D008955:Models, Cardiovascular; D009072:Moyamoya Disease / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D033081:Shear Strength; D014655:Vascular Resistance / Q000502:physiology