{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:26:22Z","timestamp":1792869982514,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010018","name":"Doctoral Start-up Foundation of Liaoning Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010018","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>By dictating local hemodynamics, vascular geometry played a critical role in atherosclerosis (AS). The objective of this research was to clarify how the vertebro-subclavian artery (VA-SCA) angle affected local blood flow patterns in the pathophysiology of AS at the vertebral artery origin (VAO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This research integrated clinical retrospective analysis with computational fluid dynamics (CFD) simulation. The clinical component examined 364 VAs and classified them into Plaque\/Stenosis-free and Plaque\/Stenosis groups based on DSA images. Baseline data and morphological parameters (VAO length, tortuosity, VA-SCA angles, and lateralisation) were analysed and compared between the two groups. For the CFD component, idealised geometric models with variable VA-SCA angles were established, and a comprehensive investigation was conducted to elucidate the effects of angle variations on the medial and lateral walls of the VAO region with respect to time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and hemodynamic flow field characteristics. Furthermore, these hemodynamic trends derived from parametric modelling have been validated by patient-specific data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In this retrospective clinical study, multivariate regression analysis revealed that a larger VA-SCA angle (\n                      <jats:italic>OR<\/jats:italic>\n                      = 1.84,\n                      <jats:italic>95% CI<\/jats:italic>\n                      : 1.46\u20132.33,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and severe curvature (\n                      <jats:italic>OR<\/jats:italic>\n                      = 2.35,\n                      <jats:italic>95% CI:<\/jats:italic>\n                      1.21\u20134.56,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.011) were independent risk factors for AS at the VAO. CFD simulations indicated that across all angle configurations, the lateral VAO wall consistently showed lower TAWSS and higher OSI than the medial wall, with vortex formation observed in all models. With an increase in the VA-SCA angle, the lateral wall TAWSS initially decreased before increasing again, attaining its minimum at 50\u00b0, whereas the OSI displayed an opposite trend, peaking at 70\u00b0. Analysis of patient-specific data further confirmed that, as the VA-SCA angle increases, TAWSS initially decreases, then increases. At the same time, OSI shows an initial increase followed by a decline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The VA-SCA angle may influence the pathogenesis of AS at the VAO through hemodynamic factors and could serve as a new imaging biomarker to assess hemodynamics in this context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1775214","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:35:30Z","timestamp":1776749730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The vertebro-subclavian artery angle modulates hemodynamic mechanisms of atherosclerosis in vertebral artery origin: a combined clinical and computational fluid dynamics study"],"prefix":"10.3389","volume":"14","author":[{"given":"Ligang","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, General Hospital of the Northern Theatre Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuangzhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital of the Northern Theatre Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaogang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital of the Northern Theatre Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guobiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital of the Northern Theatre Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s00276-005-0060-1","article-title":"Atherosclerosis in the vertebral artery: an intrinsic risk factor in the use of spinal manipulation?","volume":"28","author":"Cagnie","year":"2006","journal-title":"Surg. Radiol. Anat."},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/jnis-2024-022618","article-title":"Endovascular management of extracranial vertebral artery stenosis","volume":"18","author":"Chen","year":"","journal-title":"J. Neurointerv Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"031005","DOI":"10.1115\/1.4067578","article-title":"Influence of geometric parameters on the hemodynamic characteristics of the vertebral artery","volume":"147","author":"Chen","year":"","journal-title":"J. Biomech. Eng."},{"key":"B4","doi-asserted-by":"publisher","first-page":"9877","DOI":"10.3390\/ijms25189877","article-title":"Wall shear stress (WSS) analysis in atherosclerosis in partial ligated apolipoprotein E knockout mouse model through computational Fluid Dynamics (CFD)","volume":"25","author":"Cho","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e037129","DOI":"10.1161\/jaha.124.037129","article-title":"Advances in the computational assessment of disturbed coronary flow and Wall shear stress: a contemporary review","volume":"13","author":"Ekmejian","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/s1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global Burden of disease study 2019","volume":"20","year":"2021","journal-title":"Lancet Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.atherosclerosis.2020.11.002","article-title":"Role of mechanical stress and neutrophils in the pathogenesis of plaque erosion","volume":"318","author":"Gr\u00e9gory","year":"2021","journal-title":"Atherosclerosis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1038\/s42003-022-04014-3","article-title":"Angular difference in human coronary artery governs endothelial cell structure and function","volume":"5","author":"Katakia","year":"2022","journal-title":"Commun. Biol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"4010","DOI":"10.3390\/jcm13144010","article-title":"Percutaneous transluminal angioplasty for atherosclerotic stenosis of vertebral artery origin","volume":"13","author":"Kraj\u00ed\u010dkov\u00e1","year":"2024","journal-title":"J. Clin. Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"710","DOI":"10.5603\/FM.a2019.0039","article-title":"The applied anatomy and clinical significance of the proximal, V1 segment of vertebral artery","volume":"78","author":"Li","year":"2019","journal-title":"Folia Morphol. Warsz."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e41973","DOI":"10.1016\/j.heliyon.2025.e41973","article-title":"Machine learning-based prediction of hemodynamic parameters in left coronary artery bifurcation: a CFD approach","volume":"11","author":"Malek","year":"2025","journal-title":"Heliyon"},{"key":"B12","doi-asserted-by":"publisher","first-page":"104070","DOI":"10.1016\/j.ijengsci.2024.104070","article-title":"Nonlinear biomechanics of diseased carotid arteries","volume":"199","author":"Moghadasi","year":"","journal-title":"Int. J. Eng. Sci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"106760","DOI":"10.1016\/j.jmbbm.2024.106760","article-title":"Nonlinear biomechanical behaviour of extracranial carotid artery aneurysms in the framework of windkessel effect via FSI technique","volume":"160","author":"Moghadasi","year":"","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.physrep.2025.10.008","article-title":"A review on computational assessment of biomedical markers in carotid arteries","volume":"1155","author":"Moghadasi","year":"2026","journal-title":"Phys. Rep."},{"key":"B15","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1007\/s11517-018-1904-2","article-title":"Correlation between geometric parameters of the left coronary artery and hemodynamic descriptors of atherosclerosis: FSI and statistical study","volume":"57","author":"Pinho","year":"2019","journal-title":"Med. Biol. Eng. Comput."},{"key":"B16","doi-asserted-by":"publisher","first-page":"104015","DOI":"10.1016\/j.compbiomed.2020.104015","article-title":"Spatiotemporal transfer of nitric oxide in patient-specific atherosclerotic carotid artery bifurcations with MRI and computational fluid dynamics modeling","volume":"125","author":"Qian","year":"2020","journal-title":"Comput. Biol. Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"207","DOI":"10.2147\/vhrm.S453352","article-title":"Retrospective cohort angiographic analysis of vertebral artery dominance, stenosis patterns, and demographic correlations","volume":"20","author":"Qtaish","year":"2024","journal-title":"Vasc. Health Risk Manag."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s00397-023-01402-2","article-title":"Physiology-based parameterization of human blood steady shear rheology via machine learning: a hemostatistics contribution","volume":"62","author":"Sean","year":"2023","journal-title":"Rheologica Acta Int. J. Rheology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1002\/jum.14692","article-title":"Topography of vertebral artery origin plaques: characteristics and determinants","volume":"38","author":"Simonetto","year":"2019","journal-title":"J. Ultrasound Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"537","DOI":"10.21037\/qims.2017.10.03","article-title":"An investigation of correlation between left coronary bifurcation angle and hemodynamic changes in coronary stenosis by coronary computed tomography angiography-derived computational fluid dynamics","volume":"7","author":"Sun","year":"2017","journal-title":"Quant. Imaging Med. Surg."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2228","DOI":"10.1007\/s10439-015-1492-3","article-title":"Effects of vessel tortuosity on coronary hemodynamics: an idealized and patient-specific computational study","volume":"44","author":"Vorobtsova","year":"2016","journal-title":"Ann. Biomed. Eng."},{"key":"B23","doi-asserted-by":"publisher","first-page":"e2307627","DOI":"10.1002\/advs.202307627","article-title":"Integrating computational and biological hemodynamic approaches to improve modeling of atherosclerotic arteries","volume":"11","author":"Vuong","year":"2024","journal-title":"Adv. Sci. (Weinh)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1159\/000514138","article-title":"Case report: evaluating biomechanical risk factors in carotid stenosis by patient-specific fluid-structural interaction biomechanical analysis","volume":"50","author":"Wang","year":"2021","journal-title":"Cerebrovasc. Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1831","DOI":"10.1007\/s11517-020-02185-x","article-title":"Coronary arteries hemodynamics: effect of arterial geometry on hemodynamic parameters causing atherosclerosis","volume":"58","author":"Wong","year":"2020","journal-title":"Med. Biol. Eng. Comput."},{"key":"B26","doi-asserted-by":"publisher","first-page":"20121053","DOI":"10.1098\/rsif.2012.1053","article-title":"In vitro and in vivo investigations on the effects of low-density lipoprotein concentration polarization and haemodynamics on atherosclerotic localization in rabbit and zebrafish","volume":"10","author":"Xie","year":"2013","journal-title":"J. R. Soc. Interface"},{"key":"B27","doi-asserted-by":"publisher","first-page":"4896","DOI":"10.1038\/s41598-025-89100-2","article-title":"Hemodynamic effects of stenosis with varying severity in different segments of the carotid artery using computational fluid dynamics","volume":"15","author":"Yang","year":"2025","journal-title":"Sci. Rep."},{"key":"B28","doi-asserted-by":"publisher","first-page":"52","DOI":"10.5935\/1678-9741.20150071","article-title":"Aberrant origin of vertebral artery and its clinical implications","volume":"31","author":"Yuan","year":"2016","journal-title":"Braz J. Cardiovasc Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s00270-010-9953-4","article-title":"Influence of vessel size and tortuosity on in-stent restenosis after stent implantation in the vertebral artery ostium","volume":"34","author":"Zhou","year":"2011","journal-title":"Cardiovasc Interv. Radiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s13760-015-0570-5","article-title":"Study on the correlation of vertebral artery dominance, basilar artery curvature and posterior circulation infarction","volume":"116","author":"Zhu","year":"2016","journal-title":"Acta Neurol. Belg"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1775214\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:35:33Z","timestamp":1776749733000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1775214\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":30,"alternative-id":["10.3389\/fbioe.2026.1775214"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2026.1775214","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"article-number":"1775214"}}