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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1455989
This article is part of the Research Topic Stroke and Cerebrovascular Disease in young adults View all 9 articles

Investigating the Pathophysiology and Evolution of Internal Carotid Dissection: A Fluid-Structure Interaction Simulation Study

Provisionally accepted
Adriano Bonura Adriano Bonura 1,2Giulio Musotto Giulio Musotto 3Gianmarco Iaccarino Gianmarco Iaccarino 1,2Sergio S. Rossi Sergio S. Rossi 1,2Rosalinda Calandrelli Rosalinda Calandrelli 4Fioravante Capone Fioravante Capone 1,2Vincenzo Di Lazzaro Vincenzo Di Lazzaro 1,2Fabio Pilato Fabio Pilato 1,2*
  • 1 Research Unit of Neurology, Department of Medicine and Surgery,, Campus Bio-Medico University Hospital, Roma, Italy
  • 2 Campus Bio-Medico University Hospital Foundation, Rome, Lazio, Italy
  • 3 Bioengineering Unit, Ri.MED Foundation, Palermo, Sicily, Italy
  • 4 4. Radiology and Neuroradiology Unit, Department of Imaging, Radiation Therapy and Hematology,, Agostino Gemelli University Polyclinic (IRCCS), Rome, Lazio, Italy

The final, formatted version of the article will be published soon.

    Background: Arterial dissection, a condition marked by the tearing of the carotid artery's inner layers, can result in varied clinical outcomes, including progression, stability, or spontaneous regression. Understanding these outcomes' underlying mechanisms is crucial for enhancing patient care, particularly with the increasing use of computer simulations in medical diagnostics and treatment planning. The aim of this study is to utilize computational analysis of blood flow and vascular wall to: (1) understand the pathophysiology of stroke-like episodes in patients with carotid artery dissection; (2) assess the effectiveness of this method in predicting the evolution of carotid dissection.Methods: Utilizing contrast-enhanced magnetic resonance angiography (MRA), we segmented images of the patient's right internal carotid artery. These images were transformed into 3D solids for simulation in Ansys multifisic software, employing a two-way fluid structure interaction (FSI) analysis. Simulations were conducted across two wall conditions (atherosclerotic and normal) and three pressure states (hypotension, normotension, hypertension).The simulations indicated a significant pressure discrepancy between the true and false lumens of the artery. This suggests that flap motion and functional occlusion under hypertensive conditions could be the cause of the clinical episodes. Thrombotic risk and potential for dissection extension were not found to be critical concerns. However, a non-negligible risk of vessel dilation was assessed, aligning with the patient's clinical follow-up data.This study highlights specific hemodynamic parameters that could elucidate carotid artery dissection's mechanisms, offering a potential predictive tool for assessing dissection progression and informing personalized patient care strategies.

    Keywords: Stroke, Fluid Dynamics, Internal carotid dissection, Fluid structural interaction (FSI), Computer Simulation

    Received: 27 Jun 2024; Accepted: 09 Sep 2024.

    Copyright: © 2024 Bonura, Musotto, Iaccarino, Rossi, Calandrelli, Capone, Di Lazzaro and Pilato. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fabio Pilato, Research Unit of Neurology, Department of Medicine and Surgery,, Campus Bio-Medico University Hospital, Roma, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.