THE COMPUTATIONAL STUDY OF THE EFFECT OF INDIVIDUAL DIFFERENCES IN CEREBRAL BLOOD VESSELS ON THE STRATEGY OF ACP
Lu Han, Jinlong Liu, Wei Wang
Shanghai Children’s Medical Center, China
Antegrade celebral perfusion (ACP) is the most common used method of perfusion in aortic arch surgery. It includes two types of approaches; the unilateral perfusion and the bilateral perfusion. Human studies indicated that more than 90% of the human have the circle of wills (CoW), but still a few people are cerebral artery stenosis or Cow uncomplete. This increases the complication of ACP investigation. How to choose an appropriate method of ACP for the individual therapies becomes a complex issue in surgeries. In the present study, we introduced the method of computational fluid dynamics (CFD) to quantitatively study the effects of the two types of perfusion. The CT images were used to reconstruct an individual three-dimensional (3D) model of cerebral arteries. The pulsatile blood flow measured by Trans-Cranial Doppler ultrasonography (TCD) was applied as boundary conditions for CFD simulations. Hemodynamic parameters in the 3D cerebral vascular model were compared among the patients with the existence or absence Circle of Willis at the condition of the unilateral and bilateral antegrade selective cerebral perfusion. The effects of stenotic degree of the cerebral vessels and the different stenotic positions were also investigated. The computational results indicated there were no obvious differences between the unilateral cerebral perfusion and bilateral cerebral perfusion in most patients. For few patients, the unilateral cerebral perfusion is not suitable to avoid brain injury.