Rossitti S, Löfgren J
Department of Neurosurgery, University of Göteborg, Sahlgrenska Hospital, Sweden.
Stroke. 1993 Jul;24(7):1029-32. doi: 10.1161/01.str.24.7.1029.
The cerebral arteries present an optimum blood flow/vessel radius relation. However, branch angles may vary widely in the cerebral arteries because the parametric optimization of branch angles is irrelevant in terms of energy cost. The position of the flow divider in extracranial arteries has been suggested to be optimum in flow orderliness. No data exist on the flow divider of cerebral arteries. Thus, we hypothesized that in the cerebral arteries the apex of the bifurcations, which is known to be the site of maximum hemodynamic stress in a vascular network, may normally lie in a non-optimum position relative to the dividing flow streamline in the parent vessel, leading to disturbed laminar flow and increased vessel wall shear stress at the apical region despite the optimum blood flow/vessel radius relation. The objective of this study was to test our hypothesis.
We measured the branch angles and diameters of parent and branch segments of the anterior cerebral artery system from lateral projections to minimize the measurement error on angiographs chosen at random from normal sets. The position of the apex of the bifurcations in relation to the ostium of the parent artery (gamma) and the ratio of the branch diameters (d2/d1) were compared. Optimum curves for these parameters were calculated by a mathematical model. In addition, the separation of flow streamlines according to gamma was calculated for each bifurcation and related to the division of flow required by each branch according to the optimum blood flow/vessel radius relation.
The data points on gamma and d2/d1 and the separation of flow according to gamma and the division of flow required by the branches were found to scatter around the optimum curves. However, a trend toward the theoretical optimum is discernible. The data points are suggested to be a random sample from a normal distribution around the optimum (.40 < P < .50).
The bifurcations of the cerebral arteries appear to be optimized to avoid increased hemodynamic stresses both globally and locally in the same manner as extracranial arteries.
脑动脉呈现出最佳的血流/血管半径关系。然而,脑动脉中的分支角度可能差异很大,因为从能量消耗角度来看,分支角度的参数优化并无关联。有观点认为,颅外动脉中分流器的位置在血流有序性方面是最佳的。目前尚无关于脑动脉分流器的数据。因此,我们推测,在脑动脉中,已知是血管网络中血流动力学应力最大部位的分叉顶点,相对于母血管中分流流线而言,其位置可能通常并非最佳,尽管血流/血管半径关系处于最佳状态,但仍会导致顶端区域层流紊乱和血管壁剪切应力增加。本研究的目的是验证我们的推测。
我们从侧位投影测量大脑前动脉系统母段和分支段的分支角度及直径,以尽量减少从正常组中随机选取的血管造影图像上的测量误差。比较了分叉顶点相对于母动脉开口的位置(γ)以及分支直径之比(d2/d1)。通过数学模型计算这些参数的最佳曲线。此外,针对每个分叉计算根据γ的流线分离情况,并将其与根据最佳血流/血管半径关系每个分支所需的血流分配相关联。
发现γ和d2/d1的数据点以及根据γ的血流分离情况和分支所需的血流分配情况均围绕最佳曲线分散。然而,可以看出向理论最佳状态的趋势。这些数据点被认为是围绕最佳值的正态分布的随机样本(0.40 < P < 0.50)。
脑动脉的分叉似乎以与颅外动脉相同的方式进行了优化,以避免整体和局部血流动力学应力增加。