The role of leptomeningeal collaterals in redistributing blood flow during stroke

作者：Robert Epp, Chaim Glück, Nadine Felizitas Binder, Mohamad El Amki, Bruno Weber, Susanne Wegener, Patrick Jenny, Franca Schmid · 发表于：PLoS Computational Biology · 年份：2023 · DOI：10.1371/journal.pcbi.1011496 · 被引用次数：17 · 研究领域：Advanced MRI Techniques and Applications、Photoacoustic and Ultrasonic Imaging、Advanced Neuroimaging Techniques and Applications

Leptomeningeal collaterals (LMCs) connect the main cerebral arteries and provide alternative pathways for blood flow during ischaemic stroke. This is beneficial for reducing infarct size and reperfusion success after treatment. However, a better understanding of how LMCs affect blood flow distribution is indispensable to improve therapeutic strategies. Here, we present a novel in silico approach that incorporates case-specific in vivo data into a computational model to simulate blood flow in large semi-realistic microvascular networks from two different mouse strains, characterised by having many and almost no LMCs between middle and anterior cerebral artery (MCA, ACA) territories. This framework is unique because our simulations are directly aligned with in vivo data. Moreover, it allows us to analyse perfusion characteristics quantitatively across all vessel types and for networks with no, few and many LMCs. We show that the occlusion of the MCA directly caused a redistribution of blood that was characterised by increased flow in LMCs. Interestingly, the improved perfusion of MCA-sided microvessels after dilating LMCs came at the cost of a reduced blood supply in other brain areas. This effect was enhanced in regions close to the watershed line and when the number of LMCs was increased. Additional dilations of surface and penetrating arteries after stroke improved perfusion across the entire vasculature and partially recovered flow in the obstructed region, especially in ne...