Shape changes at the apex of isolated human cerebral bifurcations with changes in transmural pressure.

Abstract

The geometry of arterial bifurcations appears to play a significant role in the development of vascular disease. We have investigated the changes in bifurcation geometry with changes in distending pressure over the range 0.0 to 190.0 mm Hg. Five cerebral arterial bifurcations from human subjects were studied. The investigation focussed on the shape and on changes in the shape of the leading edge of the flow divider (internal apical curve). The curve outline at each transmural pressure increment (each 10.0 mm Hg) was photographed and digitized. The curves were plotted serially on an expanded scale. Visual comparison of the curves indicated flattening in the central region and broadening of the shoulders of the curves with increasing transmural pressure. Regression analysis using second order polynomials was used to obtain coefficients for equations defining short, overlapping segments of each curve. Twenty-four coordinates were used for each successive regression. Each curve was characterized by 85 to 100 digitized coordinates. The regression equations for each curve were used to calculate the curvature parameter, K, and the radius of curvature, R. Three of the five bifurcations demonstrated a negative correlation of K with increasing transmural pressure (p less than .001). This result supports the visual observation that the internal apical curve flattens with increasing transmural pressure. Flattening of the internal apical curve together with thinning of the arterial wall with increasing transmural pressure would contribute to a stress concentration at the apex of a cerebral bifurcation. This stress concentration would be more pronounced in the presence of a medial gap at the apex of the bifurcation. It is on or near this region of stress concentration that aneurysms develop.