"Use of computational haemodynamics technology is well described for a number of diverse conditions in medicine including predicting flows in the Circle of Willis, risk of rupture of aneurysms, and optimum endovascular stent placement in the management of vascular pathology. Saphenous vein or radial artery interposition grafts are often used for high-flow extracranial-intracranial bypass procedures. These bypasses have the potential to supply a considerable volume of cerebral blood flow to the brain. However, long-term patency for specific graft types remains unknown. This is a computation haemodynamic analysis of consecutive interposition bypass cases. The bypasses are between the common carotid artery (CCA) and intracranial Internal carotid artery (ICA) or middle cerebral artery (MCA). Emerging evidence supports a pathogenic role of abnormal wall shear stress (WSS) and pressure turbulence flow as important factors in the development of early graft failure at the anastomotic site. This study aimed to develop a computational fluid dynamics simulator for assessing flow in cerebral high flow revascularisation bypass grafts and to study the impact of variations in the anastomosis angle and pressure gradient across bypass. Also the optimum mean arterial pressure required for maintaining the graft flow was investigated.
Table of Contents1. High flow extracranial-to-intracranial brain bypass surgery. Review -- 2. Comparative patency between intracranial arterial pedicle and vein bypass surgery -- 3. Measuring competence development for performing high flow extracranial-to-intracranial bypass -- 4. Computational haemodynamic fluid analysis in high flow extracranial to intracranial bypass surgery -- 5. Evaluation of brain extracranial-to-intracranial (EC-IC) bypass treatments by using computational haemodynamic technology -- 6. Haemodynamic effects resulting from a common carotid to middle cerebral bypass with varying degrees of proximal internal carotid stenosis -- 7. Mean arterial pressure required for maintaining patency of high flow extracranial to intracranial bypass grafts: an investigation with computational haemodynamic models. Case series -- 8. Flow resistance analysis of high flow extracranial-to-intracranial bypass -- 9. Thesis discussion and conclusion -- Appendices.
NotesIncludes bibliographical references
A thesis submitted to fulfil the requirements for the degree of Doctor of Philosophy at the Australian School of Advanced Medicine, Faculty of Human Sciences, Macquarie University, Sydney".
Awarding InstitutionMacquarie University
Degree TypeThesis PhD
DegreePhD, Macquarie University, Faculty of Human Science, Australian School of Advanced Medicine
Department, Centre or SchoolAustralian School of Advanced Medicine
Year of Award2012
Principal SupervisorMichael Morgan
RightsCopyright disclaimer: http://www.copyright.mq.edu.au
Copyright Sheau Fung Sia 2012.
Extent1 online resource (xxii, 222 pages) illustrations, portrait +