Predilections of Cardiogenic Embolic Transport to the Cerebral Versus Peripheral Arteries

One of the most compelling scenarios of embolic transport is for cardiogenic particles. These emboli are a major cause of death and disability, resulting in an estimated 20%–30% of ischemic brain strokes. Whether cardiogenic emboli continue distally in the descending aorta, or travel into the aortic branch arteries has critical consequences for stroke. Previous studies found that embolic particles tend to favor larger diameter arteries at bifurcations, which suggests that cardiogenic emboli should be preferentially transported to the descending aorta, even beyond expectations due to flow rate. However, extrapolating previous findings to this scenario is questionable because previous models do not represent the unique fluid dynamics and morphology of the ascending aorta. We utilized medical imaging and computational modeling to better understand the transport of cardiac emboli to the cerebral arteries. Results indicate that particle transport to aortic branch arteries, and subsequently the arteries to the head, has a strong size-destination predilection that varies markedly from volumetric blood flow distribution.