Carotid Artery Blood Flow Patterns in Embolic Stroke of Undetermined Source

Strokes without obvious cause are known as embolic strokes of undetermined source (ESUS). ESUS is currently defined as having both intracranial and extracranial arteries with less than 50% stenosis and lacking other identifiable causes. The uncertainty behind ESUS mechanisms challenges treatment and secondary stroke prevention. This study aims to use patient-specific computational fluid dynamics (CFD) to identify ESUS biomarkers. 3D computer models of the left and right carotid arteries for a cohort of ESUS patients and healthy subjects are constructed from CT scan data. CFD analysis is performed on each geometry to model pulsatile blood flow and study the hemodynamics. Quantitative and qualitative analysis is performed on the patients to identify hemodynamic biomarkers associated with stroke in a cross-sectional study. Standard wall shear stress (WSS) metrics and WSS topology are considered in the analysis. By integrating hemodynamic analysis with imaging data, our understanding of ESUS mechanisms can be improved enabling better clinical diagnostics.