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The Effect of Head Rotation on the Geometry and Hemodynamics of Healthy Vertebral Arteries

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Abstract

The geometric and hemodynamic characteristics of the left and right vertebral arteries (LVA, RVA) of six healthy volunteers were investigated for the supine (S) and the prone position (P) a common sleeping posture with head rotation. MRI images were used to reconstruct the subject specific three-dimensional solid models of the LVA and RVA from the level of the carotid bifurcation to the vertebrobasilar junction (VJ). Geometric parameters such as cross sectional area ratio, curvature, tortuosity and branch angle were estimated. MR-PCA was used to obtain the blood flow waveforms for the two positions and computational fluid dynamics (CFD) were used to assess the flow field in terms of wall shear stress (WSS) relative residence times (RRT) and localized normalized helicity (LNH). Significant geometric changes but moderate flow changes were observed for both vertebral arteries with head rotation. The CFD results at the VJ show that head rotation causes changes in the WSS distribution, RRT and LNH. Further studies are warranted to assess the clinical significance of the results in terms of atherosclerosis development at the VJ and how the observed geometric changes may affect blood flow to the brain in healthy subjects and vertebral artery stenosis patients, and in terms of increased rapture susceptibility in vertebrobasilar aneurysm patients.

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References

  1. Albanese, E., A. Russo, and A. J. Ulm. Fenestrated vertebrobasilar junction aneurysm: diagnostic and therapeutic considerations. J. Neurosurg. 110:525–529, 2009.

    Article  PubMed  Google Scholar 

  2. Antiga, L., and D. A. Steimman. Robust and objective decompositionand mapping of bifurcating vessels. IEEE Trans. Med. Imaging 23:704–713, 2004.

    Article  PubMed  Google Scholar 

  3. Aristokleous, N., I. Seimenis, Y. Papaharilaou, G. C. Georgiou, B. C. Brott, E. Eracleous, and A. S. Anayiotos. Effect of posture change on the geometric features of the healthy carotid bifurcation. IEEE Trans. Inf. Technol. Biomed. 15:148–154, 2011.

    Article  PubMed  Google Scholar 

  4. Aristokleous, N., I. Seimenis, G. C. Georgiou, Y. Papaharilaou, B. C. Brott, A. Nicolaides, and A. S. Anayiotos. Impact of head rotation on the individualized common carotid flow and carotid bifurcation hemodynamics. IEEE J. Biomed. Health Inform. 18:783–789, 2014.

    Article  PubMed  Google Scholar 

  5. Brandt, T., and R. W. Baloh. Rotational vertebral artery occlusion: a clinical entity or various syndromes? Neurology 65:1156–1157, 2005.

    Article  CAS  PubMed  Google Scholar 

  6. Cebral, J. R., M. A. Castro, C. M. Putman, and N. Alperin. Flow-area relationship in internal carotid and vertebral arteries. Physiol. Meas. 29:585–594, 2008.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Choi, K. D., J. H. Choi, J. S. Kim, H. J. Kim, M. J. Kim, T. H. Lee, H. Lee, I. S. Moon, H. J. Oh, and J. I. Kim. Rotational vertebral artery occlusion: mechanisms and long-term outcome. Stroke 44:1817–1824, 2013.

    Article  PubMed  Google Scholar 

  8. Clevenger, A. C., T. Kilbaugh, and S. S. Margulies. Carotid artery blood flow decreases after rapid head rotation in piglets. J. Neurotrauma. 32:120–126, 2015.

    Article  PubMed  Google Scholar 

  9. Cloud, G. C., and H. S. Markus. Diagnosis and management of vertebral artery stenosis. QJM 96:27–54, 2003.

    Article  CAS  PubMed  Google Scholar 

  10. Cunningham, K. S., and A. I. Gotlieb. The role of shear stress in the pathogenesis of atherosclerosis. Lab. Invest. 85:9–23, 2005.

    Article  CAS  PubMed  Google Scholar 

  11. Gallo, D., D. A. Steinman, P. B. Bijari, and U. Morbiducci. Helical flow in carotid bifurcation as surrogate marker of exposure to disturbed shear. J. Biomech. 45:2398–2404, 2012.

    Article  PubMed  Google Scholar 

  12. Gallo, D., D. A. Steinman, and U. Morbiducci. An insight into the mechanistic role of the common carotid artery on the hemodynamics at the carotid bifurcation. Ann. Biomed. Eng. 43:68–81, 2015.

    Article  PubMed  Google Scholar 

  13. Glor, F. P., B. Ariff, A. D. Hughes, P. R. Verdonck, D. C. Barratt, A. D. Augst, S. A. Thom, and X. Y. Xu. Influence of head position on carotid hemodynamics in young adults. Am. J. Physiol. Heart. Circ. Physiol. 287:H1670–H1681, 2004.

    Article  CAS  PubMed  Google Scholar 

  14. Heiberg, E., J. Sjogren, M. Ugander, M. Carlsson, H. Engblom, and H. Arheden. Design and validation of Segment–freely available software for cardiovascular image analysis. BMC Med. Imaging 10:1, 2010.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Hong, J. M., C. S. Chung, O. Y. Bang, S. W. Yong, I. S. Joo, and K. Huh. Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts. J. Neurol. Neurosurg. Psychiatr. 80:1087–1092, 2009.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Jozwik, K., and D. Obidowski. Numerical simulations of the blood flow through vertebral arteries. J. Biomech. 43:177–185, 2010.

    Article  PubMed  Google Scholar 

  17. Ku, D. N. Blood flow in arteries. Annu. Rev. Fluid Mech. 29:399–434, 1997.

    Article  Google Scholar 

  18. Ku, D. N., D. P. Giddens, C. K. Zarins, and S. Glagov. Pulsatile flow and atherosclerosis in the human carotid bifurcation—positive correlation between plaque location and low and oscillating shear-stress. Arteriosclerosis 5:293–302, 1985.

    Article  CAS  PubMed  Google Scholar 

  19. Labropoulos, N., P. Nandivada, and K. Bekelis. Prevalence and impact of the subclavian steal syndrome. Ann. Surg. 252:166–170, 2010.

    Article  PubMed  Google Scholar 

  20. Lee, S. W., L. Antiga, and D. A. Steinman. Correlations among indicators of disturbed flow at the normal carotid bifurcation. J. Biomech. Eng. 131:061013, 2009.

    Article  PubMed  Google Scholar 

  21. Malek, A. M., S. L. Alper, and S. Izumo. Hemodynamic shear stress and its role in atherosclerosis. JAMA 282:2035–2042, 1999.

    Article  CAS  PubMed  Google Scholar 

  22. Morbiducci, U., R. Ponzini, M. Grigioni, and A. Redaelli. Helical flow as fluid dynamic signature for atherogenesis risk in aortocoronary bypass. A numeric study. J. Biomech. 40:519–534, 2007.

    Article  PubMed  Google Scholar 

  23. Morbiducci, U., D. Gallo, D. Massai, F. Consolo, R. Ponzini, L. Antiga, C. Bignardi, M. A. Deriu, and A. Redaelli. Outflow conditions for image-based hemodynamic models of the carotid bifurcation: implications for indicators of abnormal flow. J. Biomech. Eng. 132:091005, 2010.

    Article  PubMed  Google Scholar 

  24. Moyle, K. R., L. Antiga, and D. A. Steinman. Inlet conditions for image-based CFD models of the carotid bifurcation: is it reasonable to assume fully developed flow? J. Biomech. Eng. 128:371–379, 2006.

    Article  PubMed  Google Scholar 

  25. Osiro, S., A. Zurada, J. Gielecki, M. M. Shoja, R. S. Tubbs, and M. Loukas. A review of subclavian steal syndrome with clinical correlation. Med. Sci. Monit. 18(5):RA57–RA63, 2012.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Papaharilaou, Y., N. Aristokleous, I. Seimenis, M. I. Khozeymeh, G. C. Georgiou, B. C. Brott, E. Eracleous, and A. S. Anayiotos. Effect of head posture on the healthy human carotid bifurcation hemodynamics. Med. Biol. Eng. Comput. 51:207–218, 2013.

    Article  PubMed  Google Scholar 

  27. Peluso, J. P., W. J. van Rooij, M. Sluzewski, and G. N. Beute. Aneurysms of the vertebrobasilar junction: incidence, clinical presentation, and outcome of endovascular treatment. AJNR Am. J. Neuroradiol. 28:1747–1751, 2007.

    Article  CAS  PubMed  Google Scholar 

  28. R. Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria, http://www.R-project.org/.

  29. Ravensbergen, J., J. W. Ravensbergen, J. K. B. Krijger, B. Hillen, and H. W. Hoogstraten. Localizing role of hemodynamics in atherosclerosis in several human vertebrobasilar junction geometries. Arterioscler. Thromb. Vasc. Biol. 18:708–716, 1998.

    Article  CAS  PubMed  Google Scholar 

  30. Ross, R. Atherosclerosis is an inflammatory disease. Am. Heart J. 138:S419–S420, 1999.

    Article  CAS  PubMed  Google Scholar 

  31. Sakaguchi, M., K. Kitagawa, H. Hougaku, H. Hashimoto, Y. Nagai, H. Yamagami, T. Ohtsuki, N. Oku, K. Hashikawa, K. Matsushita, M. Matsumoto, and M. Hori. Mechanical compression of the extracranial vertebral artery during neck rotation. Neurology 61:845–847, 2003.

    Article  CAS  PubMed  Google Scholar 

  32. Steinman, D. A., and C. A. Taylor. Flow imaging and computing: large artery hemodynamics. Ann. Biomed. Eng. 33:1704–1709, 2005.

    Article  PubMed  Google Scholar 

  33. Thomas, J. B., L. Antiga, S. L. Che, J. S. Milner, D. A. Steinman, J. D. Spence, and B. K. Rutt. Variation in the carotid bifurcation geometry of young versus older adults: implications for geometric risk of atherosclerosis. Stroke 36:2450–2456, 2005.

    Article  PubMed  Google Scholar 

  34. Yushkevich, P. A., J. Piven, H. C. Hazlett, R. G. Smith, S. Ho, J. C. Gee, and G. Gerig. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage 31:1116–1128, 2006.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors have no conflict of interest related to this study.

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, 45 Kitiou Kyprianou Str., Dorothea Bldg, 5th Floor, 3041, Limassol, Cyprus

    Nicolas Aristokleous & Andreas S. Anayiotos

  2. Laboratory of Medical Physics, Medical School, Democritus University of Thrace, Xanthi, Greece

    Ioannis Seimenis

  3. Department of Mathematics and Statistics, University of Cyprus, Nicosia, Cyprus

    Georgios C. Georgiou

  4. Department of Vascular Surgery, Imperial College, London, UK

    Andrew Nicolaides

Authors
  1. Nicolas Aristokleous
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  2. Ioannis Seimenis
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  3. Georgios C. Georgiou
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  4. Andrew Nicolaides
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  5. Andreas S. Anayiotos
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Corresponding author

Correspondence to Nicolas Aristokleous.

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Associate Editor Jane Grande-Allen oversaw the review of this article.

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Aristokleous, N., Seimenis, I., Georgiou, G.C. et al. The Effect of Head Rotation on the Geometry and Hemodynamics of Healthy Vertebral Arteries. Ann Biomed Eng 43, 1287–1297 (2015). https://doi.org/10.1007/s10439-015-1340-5

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  • DOI: https://doi.org/10.1007/s10439-015-1340-5

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