Computational Fluid Dynamics Analysis of Cerebrovascular Hemodynamic Differences in Adults with Sickle Cell Disease: Comparing Stroke and Non-Stroke Cohorts.

purposeSickle cell disease (SCD) is a debilitating genetic disorder affecting hemoglobin in red blood cells. Patients with SCD are at risk of cerebrovascular disease in the Circle of Willis (CoW), with strokes occurring from early childhood into adulthood. Despite this lifelong risk, stroke prevention guidelines using transcranial Doppler ultrasound (TCD) exist only for children, leaving a critical gap for adults. This study aimed to characterize cerebral hemodynamics in the CoW of adults with SCD to support future risk stratification and treatment guidelines.

methodsNumerical simulations were performed using 3D vascular geometries segmented from high-resolution, patient-specific magnetic resonance imaging in healthy controls (n=3), SCD patients without stroke (n=3), and SCD patients post-stroke (n=3). Key hemodynamic parameters including time-averaged wall shear stress (TAWSS), surface area exposed to low or high WSS, time-averaged mean of maximum velocity (TAMMV), and pressure drop across the CoW were quantified and compared.

resultsPreliminary results show distinct hemodynamic differences were observed across groups. SCD patients post-stroke had lower TAMMV at TCD-equivalent CoW locations (except one with ICA stenosis), the lowest average TAWSS, and the greatest surface area exposed to WSS

conclusionsPatient-specific simulations can quantify cerebral hemodynamics in adults with SCD, offering insight into stroke-related changes and informing future stroke risk assessment and personalized treatment strategies.