Article

Mechanical stresses in carotid plaques using MRI-based fluid-structure interaction models. J Biomech

MR-Center, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
Journal of Biomechanics (Impact Factor: 2.75). 02/2008; 41(8):1651-8. DOI: 10.1016/j.jbiomech.2008.03.019
Source: PubMed

ABSTRACT

Risk assessment in patients with carotid atherosclerosis relies on the degree of luminal stenosis. Incorporating morphological information on plaque composition obtained noninvasively through the use of magnetic resonance imaging (MRI) could include other variables besides the degree of stenosis into carotid plaque risk assessment. Knowledge of the morphologic composition of the plaque allows determination of mechanic stresses exerted on the protective fibrous cap, which may be of importance in the assessment of plaque vulnerability. Based on image processing of transverse MRI scans, longitudinal 2D fluid-structure interaction (FSI) simulations of carotid atherosclerotic plaques were performed facilitating in-vivo estimation of longitudinal internal fibrous cap stresses. The FSI simulation combined finite element analysis (FEA) with computational fluid dynamics (CFD) simulations of blood-flow variables. Preliminary results from two symptomatic patients revealed longitudinal stress levels (max. 254.1 and 143.2 kPa) approaching established criteria for plaque rupture at known predilection sites of plaque rupture. Determination of longitudinal fibrous cap stresses may prove useful in assessing plaque vulnerability and improve risk stratification in patients with carotid atherosclerosis.

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Available from: Won Yong Kim, Dec 23, 2013
    • "Within the atherosclerosis on coronary arteries, studies on these diseased arteries are normally focused on hemodynamic aspects, neglecting the interaction between blood flow and arterial walls, evaluating the WSS at the rigid walls and connecting it with atheromatous pathologies [18,14,19–21]. While several FSI simulations has been performed in 2D models [22] [23],3D models have also been utilized to predict wall shear stress and wall stress patterns in healthy subjects [24]. Tang and coworkers [25] [26] [27] [28] [29] [30] [31] extensively work on FSI approach of atheromatous plaque using patient specific-based models and performing statistical analysis for carotid and coronary arteries. "
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    ABSTRACT: There are many evidences that coronary plaque is not only dependent on the formation and progression of atherosclerosis, but also on the vascular remodelling response. If the local wall shear stress is low, a proliferative plaque may develop. Local inflammatory response will stimulate the formation of a plaque prone to rupture with superimposed thrombus formation (vulnerable plaque). Furthermore, the role of the wall shear stress in the genesis and the development of atherosclerotic diseases has been recently intensively investigated, examining its relationship with the presence of lesions and the intima media thickness. Due to the important role of pulsating blood flow, pressure and hemodynamics factors in atheroma growth, a Fluid Structure Interaction (FSI) parametric study of a 3D atherosclerotic artery has been carried out, with aim of studying the main geometrical risk factors in terms of plaque vulnerability.
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    • "Considering the difficulty of convergence, one-way 3D FSI (Gao et al., 2009) and 2D FSI (Kock et al., 2008; Thrysoe et al., 2010) have been used as alternatives. 3D (Kiousis et al., 2009; Teng et al., 2011) and 2D (Sadat et al., 2011a; Tang et al., 2009a) structure-only modeling have also been used for population based analyses. "
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    ABSTRACT: Stroke remains the most prevalent disabling illness today, with internal carotid artery luminal stenosis due to atheroma formation responsible for the majority of ischemic cerebrovascular events. Severity of luminal stenosis continues to dictate both patient risk stratification and the likelihood of surgical intervention. But there is growing evidence to suggest that plaque morphology may help improve pre-existing risk stratification criteria. Plaque components such a fibrous tissue, lipid rich necrotic core and calcium have been well investigated but plaque hemorrhage (PH) has been somewhat overlooked. In this review we discuss the pathogenesis of PH, its role in dictating plaque vulnerability, PH imaging techniques, marterial properties of atherosclerotic tissues, in particular, those obtained based on in vivo measurements and effect of PH in modulating local biomechanics.
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    • "Considering the difficulty of convergence, one-way 3D FSI (Gao et al., 2009) and 2D FSI (Kock et al., 2008; Thrysoe et al., 2010) have been used as alternatives. 3D (Kiousis et al., 2009; Teng et al., 2011) and 2D (Sadat et al., 2011a; Tang et al., 2009a) structure-only modeling have also been used for population based analyses. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Stroke remains the most prevalent disabling illness today, with internal carotid artery luminal stenosis due to atheroma formation responsible for the majority of ischemic cerebrovascular events. Severity of luminal stenosis continues to dictate both patient risk stratification and the likelihood of surgical intervention. But there is growing evidence to suggest that plaque morphology may help improve preexisting risk stratification criteria. Plaque components such a fibrous tissue, lipid rich necrotic core and calcium have been well investigated but plaque hemorrhage (PH) has been somewhat overlooked. In this review we discuss the pathogenesis of PH, its role in dictating plaque vulnerability, PH imaging techniques, marterial properties of atherosclerotic tissues, in particular, those obtained based on in vivo measurements and effect of PH in modulating local biomechanics.
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