{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:26:54Z","timestamp":1791390414103,"version":"4.3.3"},"reference-count":90,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Stroke remains a global health concern, necessitating early prediction for effective management. Atherosclerosis-induced internal carotid and intra cranial stenosis contributes significantly to stroke risk. This study explores the relationship between blood pressure and stroke prediction, focusing on internal carotid artery (ICA) branches: middle cerebral artery (MCA), anterior cerebral artery (ACA), and their role in hemodynamics. Computational fluid dynamics (CFD) informed by the Windkessel model were employed to simulate patient-specific ICA models with introduced stenosis. Central to our investigation is the impact of stenosis on blood pressure, flow velocity, and flow rate across these branches, incorporating Fractional Flow Reserve (FFR) analysis. Results highlight differential sensitivities to blood pressure variations, with M1 branch showing high sensitivity, ACA moderate, and M2 minimal. Comparing blood pressure fluctuations between ICA and MCA revealed heightened sensitivity to potential reverse flow compared to ICA and ACA comparisons, emphasizing MCA's role. Blood flow adjustments due to stenosis demonstrated intricate compensatory mechanisms. FFR emerged as a robust predictor of stenosis severity, particularly in the M2 branch. In conclusion, this study provides comprehensive insights into hemodynamic complexities within major intracranial arteries, elucidating the significance of blood pressure variations, flow attributes, and FFR in stenosis contexts. Subject-specific data integration enhances model reliability, aiding stroke risk assessment and advancing cerebrovascular disease understanding.<\/jats:p>","DOI":"10.1038\/s41598-023-49591-3","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T10:02:11Z","timestamp":1702634531000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Differential sensitivities to blood pressure variations in internal carotid and intracranial arteries: a numerical approach to stroke prediction"],"prefix":"10.1038","volume":"13","author":[{"given":"Muhsin","family":"Kizhisseri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh","family":"Gharaie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sethu Raman","family":"Boopathy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth P.","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milad","family":"Mohammadzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorg","family":"Schluter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"issue":"2","key":"49591_CR1","doi-asserted-by":"publisher","first-page":"e137","DOI":"10.1212\/WNL.0000000000207387","volume":"101","author":"J Fan","year":"2023","unstructured":"Fan, J. et al. Global burden, risk factor analysis, and prediction study of ischemic stroke, 1990\u20132030. Neurology 101(2), e137\u2013e150 (2023).","journal-title":"Neurology"},{"key":"49591_CR2","doi-asserted-by":"publisher","first-page":"103341","DOI":"10.1016\/j.ijengsci.2020.103341","volume":"154","author":"N Kumar","year":"2020","unstructured":"Kumar, N., Khader, S. A., Pai, R., Khan, S. & Kyriacou, E. S. Fluid structure interaction study of stenosed carotid artery considering the effects of blood pressure. Int. J. Eng. Sci. 154, 103341 (2020).","journal-title":"Int. J. Eng. Sci."},{"issue":"1","key":"49591_CR3","first-page":"69","volume":"57","author":"MSA Paisal","year":"2019","unstructured":"Paisal, M. S. A., Taib, I., Arifin, A. M. T., Darlis, F. M. & Sciences, T. An analysis of blood pressure waveform using windkessel model for normotensive and hypertensive conditions in carotid artery. J. Adv. Res. Fluid Mech. Thermal Sci. 57(1), 69\u201385 (2019).","journal-title":"J. Adv. Res. Fluid Mech. Thermal Sci."},{"issue":"5","key":"49591_CR4","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1080\/10255840903413565","volume":"13","author":"IE Vignon-Clementel","year":"2010","unstructured":"Vignon-Clementel, I. E., Figueroa, C., Jansen, K. & Taylor, C. J. C. Outflow boundary conditions for 3D simulations of non-periodic blood flow and pressure fields in deformable arteries. Comput. Methods Biomech. Biomed. Eng. 13(5), 625\u2013640 (2010).","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"issue":"4","key":"49591_CR5","first-page":"950","volume":"34","author":"M Sitzer","year":"2003","unstructured":"Sitzer, M. et al. Internal carotid artery angle of origin: A novel risk factor for early carotid atherosclerosis. Stoke 34(4), 950\u2013955 (2003).","journal-title":"Stoke"},{"issue":"11","key":"49591_CR6","doi-asserted-by":"publisher","first-page":"H1455","DOI":"10.1152\/ajpheart.00539.2012","volume":"304","author":"AI Sakellarios","year":"2013","unstructured":"Sakellarios, A. I. et al. Patient-specific computational modeling of subendothelial LDL accumulation in a stenosed right coronary artery: effect of hemodynamic and biological factors. Am. J. Physiol. Heart Circ. Physiol. 304(11), H1455\u2013H1470 (2013).","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"issue":"2","key":"49591_CR7","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/S0079-6107(03)00053-1","volume":"83","author":"SJP Chien","year":"2003","unstructured":"Chien, S. J. P. Molecular and mechanical bases of focal lipid accumulation in arterial wall. Prog. Biophys. Mol. Biol. 83(2), 131\u2013151 (2003).","journal-title":"Prog. Biophys. Mol. Biol."},{"issue":"2","key":"49591_CR8","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1161\/CIRCRESAHA.112.268144","volume":"111","author":"T Quillard","year":"2012","unstructured":"Quillard, T. & Libby, P. J. C. Molecular imaging of atherosclerosis for improving diagnostic and therapeutic development. Circ. Res. 111(2), 231\u2013244 (2012).","journal-title":"Circ. Res."},{"issue":"1\u201312","key":"49591_CR9","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.permed.2012.04.005","volume":"1","author":"D Liepsch","year":"2012","unstructured":"Liepsch, D., Balasso, A., Berger, H. & Eckstein, M. How local hemodynamics at the carotid bifurcation influence the development of carotid plaques. Perspect. Med. 1(1\u201312), 132\u2013136 (2012).","journal-title":"Perspect. Med."},{"issue":"9","key":"49591_CR10","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1016\/j.jbiomech.2016.03.037","volume":"49","author":"D Guan","year":"2016","unstructured":"Guan, D., Liang, F. & Gremaud, P. A. Comparison of the Windkessel model and structured-tree model applied to prescribe outflow boundary conditions for a one-dimensional arterial tree model. J. Biomech. 49(9), 1583\u20131592 (2016).","journal-title":"J. Biomech."},{"key":"49591_CR11","doi-asserted-by":"crossref","unstructured":"\u017byli\u0144ski, M., et al. Individualization of the parameters of the three-elements Windkessel model using carotid pulse signal. In Photonics Applications in Astronomy, Communications, Industry, and High-Energy Physics Experiments 2015, vol. 9662: International Society for Optics and Photonics, p. 96621N (2015).","DOI":"10.1117\/12.2205617"},{"issue":"11","key":"49591_CR12","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1080\/10255842.2012.744396","volume":"17","author":"M Malv\u00e8","year":"2014","unstructured":"Malv\u00e8, M. et al. Impedance-based outflow boundary conditions for human carotid haemodynamics. Comput. Methods Biomech. Biomed. Eng. 17(11), 1248\u20131260 (2014).","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"issue":"8","key":"49591_CR13","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/S0021-9290(97)00025-0","volume":"30","author":"A Delfino","year":"1997","unstructured":"Delfino, A., Stergiopulos, N., Moore, J. E. Jr. & Meister, J. J. Residual strain effects on the stress field in a thick wall finite element model of the human carotid bifurcation. J. Biomech. 30(8), 777\u2013786 (1997).","journal-title":"J. Biomech."},{"key":"49591_CR14","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s10237-004-0046-7","volume":"3","author":"HF Younis","year":"2004","unstructured":"Younis, H. F. et al. Hemodynamics and wall mechanics in human carotid bifurcation and its consequences for atherogenesis: Investigation of inter-individual variation. Biomech. Model. Mechanobiol. 3, 17\u201332 (2004).","journal-title":"Biomech. Model. Mechanobiol."},{"issue":"1","key":"49591_CR15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1159\/000350581","volume":"36","author":"P Salvi","year":"2013","unstructured":"Salvi, P., Bellasi, A. & Di Iorio, B. Does it make sense to measure only the brachial blood pressure?. Blood Purif. 36(1), 21\u201325 (2013).","journal-title":"Blood Purif."},{"issue":"4","key":"49591_CR16","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1161\/hy1001.096107","volume":"38","author":"TK Waddell","year":"2001","unstructured":"Waddell, T. K., Dart, A. M., Medley, T. L., Cameron, J. D. & Kingwell, B. A. Carotid pressure is a better predictor of coronary artery disease severity than brachial pressure. Hypertension 38(4), 927\u2013931 (2001).","journal-title":"Hypertension"},{"issue":"2","key":"49591_CR17","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1159\/000346803","volume":"1","author":"DS Liebeskind","year":"2013","unstructured":"Liebeskind, D. S. & Feldmann, E. Fractional flow in cerebrovascular disorders. Intervent. Neurol. 1(2), 87\u201399 (2013).","journal-title":"Intervent. Neurol."},{"issue":"1","key":"49591_CR18","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1111\/jon.12101","volume":"25","author":"DS Liebeskind","year":"2015","unstructured":"Liebeskind, D. S. et al. Noninvasive fractional flow on MRA predicts stroke risk of intracranial stenosis. J. Neuroimag. 25(1), 87\u201391 (2015).","journal-title":"J. Neuroimag."},{"issue":"6","key":"49591_CR19","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.jcct.2018.09.003","volume":"12","author":"E Cami","year":"2018","unstructured":"Cami, E. et al. Assessment of lesion-specific ischemia using fractional flow reserve (FFR) profiles derived from coronary computed tomography angiography (FFRCT) and invasive pressure measurements (FFRINV): Importance of the site of measurement and implications for patient referral for invasive coronary angiography and percutaneous coronary intervention. J. Cardiovasc. Comput. Tomogr. 12(6), 480\u2013492 (2018).","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"49591_CR20","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.cma.2019.05.005","volume":"353","author":"M Yin","year":"2019","unstructured":"Yin, M., Yazdani, A. & Karniadakis, G. E. One-dimensional modeling of fractional flow reserve in coronary artery disease: Uncertainty quantification and Bayesian optimization. Comput. Methods Appl. Mech. Eng. 353, 66\u201385 (2019).","journal-title":"Comput. Methods Appl. Mech. Eng."},{"issue":"7","key":"49591_CR21","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1136\/hrt.2007.122838","volume":"94","author":"B De Bruyne","year":"2008","unstructured":"De Bruyne, B. & Sarma, J. Fractional flow reserve: A review. Heart 94(7), 949\u2013959 (2008).","journal-title":"Heart"},{"key":"49591_CR22","doi-asserted-by":"crossref","unstructured":"Purkayastha, S., & Sorond, F. Transcranial Doppler ultrasound: Technique and application. In Seminars in neurology, 2012, vol. 32, no. 04: Thieme Medical Publishers, pp. 411\u2013420.","DOI":"10.1055\/s-0032-1331812"},{"key":"49591_CR23","first-page":"1","volume":"1","author":"J Naqvi","year":"2013","unstructured":"Naqvi, J., Yap, K. H., Ahmad, G. & Ghosh, J. Transcranial Doppler ultrasound: A review of the physical principles and major applications in critical care. Int. J. Vasc. Med. 1, 1 (2013).","journal-title":"Int. J. Vasc. Med."},{"key":"49591_CR24","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.3389\/fneur.2019.01372","volume":"10","author":"Z Chen","year":"2020","unstructured":"Chen, Z. et al. Characteristics of wall shear stress and pressure of intracranial atherosclerosis analyzed by a computational fluid dynamics model: A pilot study. Front. Neurol. 10, 1372 (2020).","journal-title":"Front. Neurol."},{"issue":"6","key":"49591_CR25","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1007\/s10237-018-1045-4","volume":"17","author":"P Xu","year":"2018","unstructured":"Xu, P. et al. Assessment of boundary conditions for CFD simulation in human carotid artery. Biomech. Model. Mechanobiol. 17(6), 1581\u20131597 (2018).","journal-title":"Biomech. Model. Mechanobiol."},{"key":"49591_CR26","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1161\/CIRCIMAGING.110.958504","volume":"3","author":"M Markl","year":"2010","unstructured":"Markl, M. et al. In vivo wall shear stress distribution in the carotid artery: effect of bifurcation geometry, internal carotid artery stenosis, and recanalization therapy. Circ. Cardiovasc. Imaging 3, 647\u2013655 (2010).","journal-title":"Circ. Cardiovasc. Imaging"},{"issue":"1","key":"49591_CR27","doi-asserted-by":"publisher","first-page":"e0245337","DOI":"10.1371\/journal.pone.0245337","volume":"16","author":"M Holmgren","year":"2021","unstructured":"Holmgren, M. et al. Middle cerebral artery pressure laterality in patients with symptomatic ICA stenosis. PLoS One 16(1), e0245337 (2021).","journal-title":"PLoS One"},{"key":"49591_CR28","doi-asserted-by":"publisher","first-page":"e1023","DOI":"10.1016\/j.wneu.2019.02.002","volume":"125","author":"D Ba","year":"2019","unstructured":"Ba, D. et al. Computational fluid dynamics analysis of carotid-ophthalmic aneurysms with concomitant ophthalmic artery infundibulum in a patient-specific model. World Neurosurg. 125, e1023\u2013e1033 (2019).","journal-title":"World Neurosurg."},{"key":"49591_CR29","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3389\/fnagi.2017.00140","volume":"9","author":"D-F Zhang","year":"2017","unstructured":"Zhang, D.-F. et al. A high-resolution MRI study of relationship between remodeling patterns and ischemic stroke in patients with atherosclerotic middle cerebral artery stenosis. Front Aging Neurosci. 9, 140 (2017).","journal-title":"Front Aging Neurosci."},{"issue":"7","key":"49591_CR30","doi-asserted-by":"publisher","first-page":"2567","DOI":"10.1177\/0271678X16671321","volume":"37","author":"J Liu","year":"2017","unstructured":"Liu, J. et al. Functional assessment of cerebral artery stenosis: a pilot study based on computational fluid dynamics. J. Cereb. Blood Flow Metab. 37(7), 2567\u20132576 (2017).","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"49591_CR31","doi-asserted-by":"publisher","first-page":"105185","DOI":"10.1016\/j.cmpb.2019.105185","volume":"186","author":"M Abbasian","year":"2020","unstructured":"Abbasian, M. et al. Effects of different non-Newtonian models on unsteady blood flow hemodynamics in patient-specific arterial models with in-vivo validation. Comput. Methods Programs Biomed. 186, 105185 (2020).","journal-title":"Comput. Methods Programs Biomed."},{"issue":"5","key":"49591_CR32","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/j.jbiomech.2003.09.032","volume":"37","author":"I Marshall","year":"2004","unstructured":"Marshall, I., Zhao, S., Papathanasopoulou, P., Hoskins, P. & Xu, X. Y. J. MRI and CFD studies of pulsatile flow in healthy and stenosed carotid bifurcation models. J. Biomech. 37(5), 679\u2013687 (2004).","journal-title":"J. Biomech."},{"issue":"2","key":"49591_CR33","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1166\/jmihi.2011.1018","volume":"1","author":"J Tu","year":"2011","unstructured":"Tu, J. et al. Analysis of patient-specific carotid bifurcation models using computational fluid dynamics. J. Med. Imaging Health Inf. 1(2), 116\u2013125 (2011).","journal-title":"J. Med. Imaging Health Inf."},{"issue":"4","key":"49591_CR34","first-page":"297","volume":"5","author":"T Karino","year":"1986","unstructured":"Karino, T. Microscopic structure of disturbed flows in the arterial and venous systems, and its implication in the localization of vascular diseases. Int. Angiol. J. Int. Union Angiol. 5(4), 297\u2013313 (1986).","journal-title":"Int. Angiol. J. Int. Union Angiol."},{"issue":"6","key":"49591_CR35","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.1161\/STROKEAHA.111.645499","volume":"43","author":"TG Phan","year":"2012","unstructured":"Phan, T. G. et al. Carotid artery anatomy and geometry as risk factors for carotid atherosclerotic disease. Stroke 43(6), 1596\u20131601 (2012).","journal-title":"Stroke"},{"issue":"4","key":"49591_CR36","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1002\/cnm.2529","volume":"29","author":"J Dong","year":"2013","unstructured":"Dong, J., Wong, K. K. & Tu, J. Hemodynamics analysis of patient-specific carotid bifurcation: A CFD model of downstream peripheral vascular impedance. Int. J. Numer. Methods Biomed. Eng. 29(4), 476\u2013491 (2013).","journal-title":"Int. J. Numer. Methods Biomed. Eng."},{"issue":"1","key":"49591_CR37","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1159\/000341410","volume":"40","author":"ML Flaherty","year":"2013","unstructured":"Flaherty, M. L. et al. Carotid artery stenosis as a cause of stroke. Neuroepidemiology 40(1), 36\u201341 (2013).","journal-title":"Neuroepidemiology"},{"key":"49591_CR38","first-page":"9","volume":"132","author":"U Morbiducci","year":"2010","unstructured":"Morbiducci, U. et al. Outflow conditions for image-based hemodynamic models of the carotid bifurcation: implications for indicators of abnormal flow. J. Biomed. Eng. 132, 9 (2010).","journal-title":"J. Biomed. Eng."},{"issue":"1","key":"49591_CR39","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1080\/10255840802356691","volume":"12","author":"R Balossino","year":"2009","unstructured":"Balossino, R. et al. Computational models to predict stenosis growth in carotid arteries: Which is the role of boundary conditions?. Comput. Methods Biomech. Biomed. Eng. 12(1), 113\u2013123 (2009).","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"49591_CR40","doi-asserted-by":"publisher","first-page":"3821","DOI":"10.1007\/s12206-012-1008-0","volume":"26","author":"SH Lee","year":"2012","unstructured":"Lee, S. H., Kang, S., Hur, N. & Jeong, S. K. A fluid-structure interaction analysis on hemodynamics in carotid artery based on patient-specific clinical data. J. Mech. Sci. Technol. 26, 3821\u20133831 (2012).","journal-title":"J. Mech. Sci. Technol."},{"key":"49591_CR41","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.cmpb.2017.11.016","volume":"154","author":"AA Nejad","year":"2018","unstructured":"Nejad, A. A., Talebi, Z., Cheraghali, D., Shahbani-Zahiri, A. & Norouzi, M. Pulsatile flow of non-Newtonian blood fluid inside stenosed arteries: Investigating the effects of viscoelastic and elastic walls, arteriosclerosis, and polycythemia diseases. Comput. Methods Prog. Biomed. 154, 109\u2013122 (2018).","journal-title":"Comput. Methods Prog. Biomed."},{"issue":"11","key":"49591_CR42","first-page":"1923","volume":"8","author":"SA Khader","year":"2014","unstructured":"Khader, S. A. et al. Haemodynamics study in subject specific carotid bifurcation using FSI. Int. J. Mech. Aerosp. Ind. Mechatron. Manuf. 8(11), 1923\u20131928 (2014).","journal-title":"Int. J. Mech. Aerosp. Ind. Mechatron. Manuf."},{"issue":"1\u20133","key":"49591_CR43","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/S0045-7949(99)00019-X","volume":"72","author":"D Tang","year":"1999","unstructured":"Tang, D., Yang, C. & Ku, D. N. A 3-D thin-wall model with fluid\u2013structure interactions for blood flow in carotid arteries with symmetric and asymmetric stenoses. Comput. Struct. 72(1\u20133), 357\u2013377 (1999).","journal-title":"Comput. Struct."},{"key":"49591_CR44","doi-asserted-by":"publisher","first-page":"105440","DOI":"10.1016\/j.cmpb.2020.105440","volume":"192","author":"M Nagargoje","year":"2020","unstructured":"Nagargoje, M. & Gupta, R. Effect of sinus size and position on hemodynamics during pulsatile flow in a carotid artery bifurcation. Comput. Methods Prog. Biomed. 192, 105440 (2020).","journal-title":"Comput. Methods Prog. Biomed."},{"key":"49591_CR45","unstructured":"Mancini, V., Bergersen, A., Segers, P., & Valen-Sendstad, K. Investigating the numerical parameter space for a stenosed patient\u2010specific internal carotid artery model (2017)."},{"key":"49591_CR46","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1007\/s12206-017-0153-x","volume":"31","author":"M Jahangiri","year":"2017","unstructured":"Jahangiri, M., Saghafian, M. & Sadeghi, M. R. Numerical simulation of non-Newtonian models effect on hemodynamic factors of pulsatile blood flow in elastic stenosed artery. J. Mech. Sci. Technol. 31, 1003\u20131013 (2017).","journal-title":"J. Mech. Sci. Technol."},{"issue":"3","key":"49591_CR47","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1056\/NEJMoa1803538","volume":"379","author":"P Xaplanteris","year":"2018","unstructured":"Xaplanteris, P. et al. Five-year outcomes with PCI guided by fractional flow reserve. New Engl. J. Med. 379(3), 250\u2013259 (2018).","journal-title":"New Engl. J. Med."},{"key":"49591_CR48","first-page":"1","volume":"1","author":"M Wang","year":"2022","unstructured":"Wang, M. et al. Cerebral fractional flow reserve for functional evaluation of intracranial atherosclerotic stenosis. Transl. Stroke Res. 1, 1\u20133 (2022).","journal-title":"Transl. Stroke Res."},{"issue":"2","key":"49591_CR49","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/MCA.0000000000000561","volume":"29","author":"G De Luca","year":"2018","unstructured":"De Luca, G., Verdoia, M., Barbieri, L., Marino, P. & Suryapranata, H. Resting P d\/P a and haemodynamic relevance of coronary stenosis as evaluated by fractional flow reserve. Coronary Artery Dis. 29(2), 138\u2013144 (2018).","journal-title":"Coronary Artery Dis."},{"issue":"1","key":"49591_CR50","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1515\/cdbme-2018-0141","volume":"4","author":"S Vo\u00df","year":"2018","unstructured":"Vo\u00df, S. et al. Fluid-structure interaction in intracranial vessel walls: The role of patient-specific wall thickness. Curr. Direct. Biomed. Eng. 4(1), 587\u2013590 (2018).","journal-title":"Curr. Direct. Biomed. Eng."},{"key":"49591_CR51","doi-asserted-by":"crossref","unstructured":"Bazilevs, Y., Takizawa, K., & Tezduyar, T. E. Computational fluid-structure interaction: methods and applications (John Wiley & Sons, 2013).","DOI":"10.1002\/9781118483565"},{"key":"49591_CR52","doi-asserted-by":"publisher","first-page":"105222","DOI":"10.1016\/j.ijmecsci.2019.105222","volume":"165","author":"R Savabi","year":"2020","unstructured":"Savabi, R., Nabaei, M., Farajollahi, S. & Fatouraee, N. Fluid structure interaction modeling of aortic arch and carotid bifurcation as the location of baroreceptors. Int. J. Mech. Sci. 165, 105222 (2020).","journal-title":"Int. J. Mech. Sci."},{"key":"49591_CR53","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.medengphy.2020.01.008","volume":"78","author":"M Hirschhorn","year":"2020","unstructured":"Hirschhorn, M., Tchantchaleishvili, V., Stevens, R., Rossano, J. & Throckmorton, A. Fluid\u2013structure interaction modeling in cardiovascular medicine\u2013A systematic review 2017\u20132019. Med. Eng. Phys. 78, 1\u201313 (2020).","journal-title":"Med. Eng. Phys."},{"issue":"2","key":"49591_CR54","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.icheatmasstransfer.2008.10.006","volume":"36","author":"A Valencia","year":"2009","unstructured":"Valencia, A. & Baeza, F. Numerical simulation of fluid\u2013structure interaction in stenotic arteries considering two layer nonlinear anisotropic structural model. Int. Commun. Heat Mass Transfer 36(2), 137\u2013142 (2009).","journal-title":"Int. Commun. Heat Mass Transfer"},{"key":"49591_CR55","unstructured":"Shaik, E. Numerical simulations of blood flow in arteries using fluid-structure interactions (Wichita State University, 2007)."},{"key":"49591_CR56","unstructured":"Liffman, K., & Bui, A. A study of fluid and structure interaction in a carotid bifurcation (2006)."},{"issue":"8","key":"49591_CR57","doi-asserted-by":"publisher","first-page":"e02722","DOI":"10.1002\/cnm.2722","volume":"31","author":"J Yuan","year":"2015","unstructured":"Yuan, J. et al. Influence of material property variability on the mechanical behaviour of carotid atherosclerotic plaques: A 3D fluid-structure interaction analysis. Int. J. Num. Methods Biomed. Eng. 31(8), e02722 (2015).","journal-title":"Int. J. Num. Methods Biomed. Eng."},{"key":"49591_CR58","unstructured":"Khader, S. A., Kumar, N., & Pai, R. Fluid structure interaction study of stenosed carotid artery considering the effects of blood pressure and altered gravity. In Finite Element Methods and Their Applications (IntechOpen, 2020)."},{"issue":"6","key":"49591_CR59","doi-asserted-by":"publisher","first-page":"2595","DOI":"10.3390\/app11062595","volume":"11","author":"J Barahona","year":"2021","unstructured":"Barahona, J., Valencia, A. & Torres, M. Study of the Hemodynamics effects of an isolated systolic hypertension (ISH) condition on cerebral aneurysms models, using FSI simulations. Appl. Sci. 11(6), 2595 (2021).","journal-title":"Appl. Sci."},{"issue":"3","key":"49591_CR60","doi-asserted-by":"publisher","first-page":"357","DOI":"10.3233\/BME-181732","volume":"29","author":"M Jahed","year":"2018","unstructured":"Jahed, M., Ghalichi, F. & Farhoudi, M. Fluid-structure interaction of patient-specific Circle of Willis with aneurysm: Investigation of hemodynamic parameters. Bio-med. Mater. Eng. 29(3), 357\u2013368 (2018).","journal-title":"Bio-med. Mater. Eng."},{"issue":"3","key":"49591_CR61","volume":"5","author":"N Thiyagarajah","year":"2022","unstructured":"Thiyagarajah, N., Achey, R., Rashidi, M. & Moore, N. Z. Computational fluid-structure interactions in the human cerebrovascular system: Part 1\u2014a review of the current understanding of cerebrovascular biomechanics. J. Eng. Sci. Med. Diagn. Ther. 5(3), 030801 (2022).","journal-title":"J. Eng. Sci. Med. Diagn. Ther."},{"issue":"3","key":"49591_CR62","volume":"5","author":"R Achey","year":"2022","unstructured":"Achey, R., Thiyagarajah, N., Rashidi, K., Rashidi, M. & Moore, N. Z. Computational fluid\u2013structure interactions in the human cerebrovascular system: Part 2\u2014A review of current applications of computational fluid dynamics and structural mechanics in cerebrovascular pathophysiology. J. Eng. Sci. Med. Diagn. Ther. 5(3), 030802 (2022).","journal-title":"J. Eng. Sci. Med. Diagn. Ther."},{"key":"49591_CR63","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s00466-009-0419-y","volume":"45","author":"Y Bazilevs","year":"2009","unstructured":"Bazilevs, Y., Hsu, M.-C., Benson, D. J., Sankaran, S. & Marsden, A. L. Computational fluid\u2013structure interaction: Methods and application to a total cavopulmonary connection. Comput. Mech. 45, 77\u201389 (2009).","journal-title":"Comput. Mech."},{"key":"49591_CR64","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2021.102964","volume":"70","author":"Q Yao","year":"2021","unstructured":"Yao, Q. et al. Patient-specific hemodynamics modeling of carotid artery stenosis in a swine model based on 3D rotational angiography. Biomed. Signal Process. Control 70, 102964 (2021).","journal-title":"Biomed. Signal Process. Control"},{"issue":"1","key":"49591_CR65","doi-asserted-by":"publisher","first-page":"14973","DOI":"10.1038\/s41598-023-42004-5","volume":"13","author":"M Kizhisseri","year":"2023","unstructured":"Kizhisseri, M., Gharaie, S. & Schluter, J. An analytical method informed by clinical imaging data for estimating outlet boundary conditions in computational fluid dynamics analysis of carotid artery blood flow. Sci. Rep. 13(1), 14973 (2023).","journal-title":"Sci. Rep."},{"issue":"2","key":"49591_CR66","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1111\/j.1440-1681.2008.05010.x","volume":"36","author":"L Grinberg","year":"2009","unstructured":"Grinberg, L. et al. Large-scale simulation of the human arterial tree. Clin. Exp. Pharmacol. Physiol. 36(2), 194\u2013205 (2009).","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"issue":"9","key":"49591_CR67","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1007\/s10439-008-9527-7","volume":"36","author":"L Grinberg","year":"2008","unstructured":"Grinberg, L. et al. Outflow boundary conditions for arterial networks with multiple outlets. Ann. Biomed. Eng. 36(9), 1496\u20131514 (2008).","journal-title":"Ann. Biomed. Eng."},{"issue":"2","key":"49591_CR68","doi-asserted-by":"publisher","first-page":"R611","DOI":"10.1152\/ajpregu.00285.2001","volume":"282","author":"MS Olufsen","year":"2002","unstructured":"Olufsen, M. S., Nadim, A. & Lipsitz, L. A. Dynamics of cerebral blood flow regulation explained using a lumped parameter model. Am. J. Physiol. Regul. Integr. Compar. Physiol. 282(2), R611\u2013R622 (2002).","journal-title":"Am. J. Physiol. Regul. Integr. Compar. Physiol."},{"key":"49591_CR69","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1114\/1.1326031","volume":"28","author":"MS Olufsen","year":"2000","unstructured":"Olufsen, M. S. et al. Numerical simulation and experimental validation of blood flow in arteries with structured-tree outflow conditions. Ann. Biomed. Eng. 28, 1281\u20131299 (2000).","journal-title":"Ann. Biomed. Eng."},{"issue":"1","key":"49591_CR70","doi-asserted-by":"publisher","first-page":"H257","DOI":"10.1152\/ajpheart.1999.276.1.H257","volume":"276","author":"MS Olufsen","year":"1999","unstructured":"Olufsen, M. S. Structured tree outflow condition for blood flow in larger systemic arteries. Am. J. Physiol. Heart Circ. Physiol. 276(1), H257\u2013H268 (1999).","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"issue":"5","key":"49591_CR71","doi-asserted-by":"publisher","first-page":"e0128597","DOI":"10.1371\/journal.pone.0128597","volume":"10","author":"T Du","year":"2015","unstructured":"Du, T., Hu, D. & Cai, D. Outflow boundary conditions for blood flow in arterial trees. PLoS One 10(5), e0128597 (2015).","journal-title":"PLoS One"},{"issue":"1","key":"49591_CR72","doi-asserted-by":"publisher","first-page":"H208","DOI":"10.1152\/ajpheart.00037.2009","volume":"297","author":"P Reymond","year":"2009","unstructured":"Reymond, P., Merenda, F., Perren, F., Rufenacht, D. & Stergiopulos, N. Validation of a one-dimensional model of the systemic arterial tree. Am. J. Physiol. Heart Circ. Physiol. 297(1), H208\u2013H222 (2009).","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"issue":"2","key":"49591_CR73","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s11517-008-0359-2","volume":"47","author":"N Westerhof","year":"2009","unstructured":"Westerhof, N., Lankhaar, J. W. & Westerhof, B. E. The arterial windkessel. Med. Biol. Eng. Comput. 47(2), 131\u2013141 (2009).","journal-title":"Med. Biol. Eng. Comput."},{"issue":"4","key":"49591_CR74","doi-asserted-by":"publisher","first-page":"H1540","DOI":"10.1152\/ajpheart.1995.268.4.H1540","volume":"268","author":"NMJWN Stergiopulos","year":"1995","unstructured":"Stergiopulos, N. M. J. W. N., Meister, J. J. & Westerhof, N. Evaluation of methods for estimation of total arterial compliance. Am. J. Physiol. Heart Circ. Physiol. 268(4), H1540\u2013H1548 (1995).","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"issue":"1","key":"49591_CR75","doi-asserted-by":"publisher","first-page":"H81","DOI":"10.1152\/ajpheart.1999.276.1.H81","volume":"276","author":"N Stergiopulos","year":"1999","unstructured":"Stergiopulos, N., Westerhof, B. E. & Westerhof, N. Total arterial inertance as the fourth element of the windkessel model. Am. J. Physiol. Heart Circ. Physiol. 276(1), H81\u2013H88 (1999).","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"49591_CR76","unstructured":"Frank, O. Die grundform des arteriellen pulses. 37, 483\u2013586 (1899)."},{"key":"49591_CR77","doi-asserted-by":"publisher","first-page":"110019","DOI":"10.1016\/j.jbiomech.2020.110019","volume":"111","author":"D Lopes","year":"2020","unstructured":"Lopes, D., Puga, H., Teixeira, J. & Lima, R. Blood flow simulations in patient-specific geometries of the carotid artery: A systematic review. J. Biomech. 111, 110019 (2020).","journal-title":"J. Biomech."},{"key":"49591_CR78","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1115\/1.3005157","volume":"131","author":"AK Wake","year":"2009","unstructured":"Wake, A. K., Oshinski, J. N., Tannenbaum, A. R. & Giddens, D. P. Choice of in vivo versus idealized velocity boundary conditions influences physiologically relevant flow patterns in a subject-specific simulation of flow in the human carotid bifurcation. J. Biomech. Eng. 131, 2 (2009).","journal-title":"J. Biomech. Eng."},{"key":"49591_CR79","doi-asserted-by":"crossref","unstructured":"G. Rigatelli et al., \"Evaluation of coronary flow conditions in complex coronary artery bifurcations stenting using computational fluid dynamics: Impact of final proximal optimization technique on different double-stent techniques,\" vol. 18, no. 4, pp. 233\u2013240, 2017.","DOI":"10.1016\/j.carrev.2017.01.002"},{"issue":"1","key":"49591_CR80","first-page":"011002","volume":"4","author":"A Fuchs","year":"2021","unstructured":"Fuchs, A., Berg, N. & Prahl Wittberg, L. Pulsatile aortic blood flow\u2014a critical assessment of boundary conditions. J. Eng. Sci. Med. Diagn. Ther. 4(1), 011002 (2021).","journal-title":"J. Eng. Sci. Med. Diagn. Ther."},{"issue":"2","key":"49591_CR81","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.heliyon.2023.e13527","volume":"9","author":"M Wang","year":"2023","unstructured":"Wang, M. et al. Functional evaluation of intracranial atherosclerotic stenosis by pressure ratio measurements. Heliyon 9(2), 1 (2023).","journal-title":"Heliyon"},{"issue":"1","key":"49591_CR82","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.02.032","volume":"27","author":"H Liu","year":"2018","unstructured":"Liu, H. et al. Impact of side branches on the computation of fractional flow in intracranial arterial stenosis using the computational fluid dynamics method. J. Stroke Cerebrovasc. Dis. 27(1), 44\u201352 (2018).","journal-title":"J. Stroke Cerebrovasc. Dis."},{"issue":"5","key":"49591_CR83","doi-asserted-by":"publisher","first-page":"e97531","DOI":"10.1371\/journal.pone.0097531","volume":"9","author":"X Leng","year":"2014","unstructured":"Leng, X. et al. Computational fluid dynamics modeling of symptomatic intracranial atherosclerosis may predict risk of stroke recurrence. PLoS One 9(5), e97531 (2014).","journal-title":"PLoS One"},{"key":"49591_CR84","doi-asserted-by":"publisher","first-page":"387","DOI":"10.3389\/fneur.2017.00387","volume":"8","author":"D Pavlin-Premrl","year":"2017","unstructured":"Pavlin-Premrl, D. et al. Advanced imaging of intracranial atherosclerosis: Lessons from interventional cardiology. Front. Neurol. 8, 387 (2017).","journal-title":"Front. Neurol."},{"key":"49591_CR85","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s00259-018-3958-7","volume":"45","author":"D Agostini","year":"2018","unstructured":"Agostini, D. et al. First validation of myocardial flow reserve assessed by dynamic 99m Tc-sestamibi CZT-SPECT camera: head to head comparison with 15 O-water PET and fractional flow reserve in patients with suspected coronary artery disease. The WATERDAY study. Eur. J. Nuclear Med. Mol. Imaging 45, 1079\u20131090 (2018).","journal-title":"Eur. J. Nuclear Med. Mol. Imaging"},{"key":"49591_CR86","doi-asserted-by":"publisher","first-page":"3647","DOI":"10.1007\/s00330-019-06139-2","volume":"29","author":"M Yu","year":"2019","unstructured":"Yu, M. et al. The best predictor of ischemic coronary stenosis: Subtended myocardial volume, machine learning\u2013based FFR CT, or high-risk plaque features?. Eur. Radiol. 29, 3647\u20133657 (2019).","journal-title":"Eur. Radiol."},{"issue":"12","key":"49591_CR87","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1097\/RLI.0000000000000087","volume":"49","author":"AK Kono","year":"2014","unstructured":"Kono, A. K. et al. Relative myocardial blood flow by dynamic computed tomographic perfusion imaging predicts hemodynamic significance of coronary stenosis better than absolute blood flow. Investig. Radiol. 49(12), 801\u2013807 (2014).","journal-title":"Investig. Radiol."},{"issue":"12","key":"49591_CR88","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.1016\/j.jcin.2010.08.025","volume":"3","author":"A Ntalianis","year":"2010","unstructured":"Ntalianis, A. et al. Fractional flow reserve for the assessment of nonculprit coronary artery stenoses in patients with acute myocardial infarction. JACC Cardiovasc. Intervent. 3(12), 1274\u20131281 (2010).","journal-title":"JACC Cardiovasc. Intervent."},{"issue":"1","key":"49591_CR89","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.ihj.2015.02.025","volume":"67","author":"A Mehra","year":"2015","unstructured":"Mehra, A. & Mohan, B. Value of FFR in clinical practice. Indian Heart J. 67(1), 77\u201380 (2015).","journal-title":"Indian Heart J."},{"issue":"2","key":"49591_CR90","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1002\/ccd.26414","volume":"88","author":"YF Han","year":"2016","unstructured":"Han, Y. F. et al. Severity assessment of intracranial large artery stenosis by pressure gradient measurements: A feasibility study. Catheter. Cardiovasc. Intervent. 88(2), 255\u2013261 (2016).","journal-title":"Catheter. Cardiovasc. Intervent."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-023-49591-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-023-49591-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-023-49591-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T11:07:09Z","timestamp":1702638429000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-023-49591-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":90,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["49591"],"URL":"https:\/\/doi.org\/10.1038\/s41598-023-49591-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,15]]},"assertion":[{"value":"25 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 December 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"22319"}}