title: Local blood pressure associates with the degree of luminal stenosis in patients with atherosclerotic disease in the middle cerebral artery.
abstract: The mechanism underlying atherosclerotic ischemic events within the middle cerebral artery (MCA) is unclear. High structural stress induced by blood pressure might be a potential aetiology as plaque rupture occurs when such mechanical loading exceeds its material strength. To perform reliable analyses quantifying the mechanical loading within a plaque, the local blood pressure is needed. However, data on MCA blood pressure is currently lacking. In this study, the arterial pressure proximal to the stenotic site in the MCA was measured in 15 patients scheduled for intervention. The relationships between these local measurements and pre-intervention and intra-intervention non-invasive arm measurements were assessed. The impact of luminal stenosis on the local blood pressure was quantified. Compared with the pre-intervention arm measurement, the intra-intervention arm pressure decreased significantly by 23.9 ± 11.8 and 9.3 ± 14.7 % at diastole and systole, respectively. The pressure proximal to the stenosis was much lower than the pre-intervention arm measurement (diastole: 65.3 ± 15.7 vs 82.0 ± 9.7, p < 0.01; systole: 81.1 ± 15.9 vs 133.9 ± 18.7, p < 0.01; unit: mmHg). The systolic pressure in the MCA in patients with stenosis <70 % (n = 6) was significantly higher than the value in patients with stenosis ≥70 % (n = 9) (92.0 ± 7.3 vs 73.9 ± 16.1, p = 0.02; unit: mmHg), as was pulse pressure (22.8 ± 6.4 vs 11.1 ± 8.3, p = 0.01; unit: mmHg). However, diastolic pressure remained unaffected (69.2 ± 9.3 vs 62.8 ± 19.0, p = 0.58; unit: mmHg). In conclusion, the obtained results are helpful in understanding the local hemodynamic environment modulated by the presence of atherosclerosis. The local pressure measurements can be used for computational analysis to quantify the critical mechanical condition within an MCA lesion.
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai, 200433, China.
authors.forename: Yuanliang
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai, 200433, China.|Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
authors.forename: Wenjia
authors.initials: W
authors.lastname: Peng
authors.affiliation: Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK. zt215@cam.ac.uk.|Department of Engineering, University of Cambridge, Cambridge, UK. zt215@cam.ac.uk.
authors.forename: Zhongzhao
authors.identifier: http://orcid.org/0000-0003-3973-6157
authors.initials: Z
authors.lastname: Teng
authors.affiliation: Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Gillard
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Shanghai, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai, 200433, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai, 200433, China. cjr.lujianping@vip.163.com.
authors.forename: Jianping
authors.initials: J
authors.lastname: Lu
mesh_terms: D050197:Atherosclerosis / Q000150:complications*; D001794:Blood Pressure; D003251:Constriction, Pathologic / Q000503:physiopathology; D005260:Female; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000503:physiopathology*
keywords: Atherosclerosis; Blood pressure; Middle cerebral artery; Stenosis