Impact of CCSVI on cerebral haemodynamics: a mathematical study using MRI angiographic and flow data

• Published in: Phlebology Vol. 31; no. 5; p. 305
• Main Authors: Müller, L O, Toro, E F, Haacke, E M, Utriainen, D
• Format: Journal Article
• Language: English
• Published: England 01-06-2016
• Subjects: Cerebrovascular Circulation; Female; Humans; Magnetic Resonance Angiography; Male; Models, Cardiovascular; Vascular Malformations - diagnostic imaging; Vascular Malformations - physiopathology; CCSVI; cerebral venous hypertension; global mathematical model; MRI-derived patient-specific venous network; human circulation
• ISSN: 1758-1125
• DOI: 10.1177/0268355515586526

The presence of abnormal anatomy and flow in neck veins has been recently linked to neurological diseases. The precise impact of extra-cranial abnormalities such as stenoses remains unexplored.
Pressure and velocity fields in the full cardiovascular system are computed by means of a global mathematical model that accounts for the relationship between pulsating cerebral blood flow and intracranial pressure.
Our model predicts that extra-cranial strictures cause increased pressure in the cerebral venous system. Specifically, there is a predicted pressure increase of about 10% in patients with a 90% stenoses. Pressure increases are related to significant flow redistribution with flow reduction of up to 70% in stenosed vessels and consequent flow increase in collateral pathways.
Extra-cranial venous strictures can lead to pressure increases in intra-cranial veins of up to 1.3 mmHg, despite the shielding role of the Starling resistor. The long-term clinical implications of the predicted pressure changes are unclear.