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3D Patient-specific Modeling and Structural Finite Element Analysis of Atherosclerotic Carotid Artery Based on Computed Tomography Angiography

Overview

Overview

Journal Sci Rep

Specialty Science

Date 2023 Nov 14

PMID 37964071

Authors

Authors

Nicoletta Curcio

Antonio Rosato

Daniela Mazzaccaro

Giovanni Nano

Michele Conti

Giulia Matrone

Affiliations

Affiliations

Soon will be listed here.

Abstract

The assessment of carotid plaque vulnerability is a relevant clinical information that can help prevent adverse cerebrovascular events. To this aim, in this study, we propose a patient-specific computational workflow to quantify the stress distribution in an atherosclerotic carotid artery, by means of geometric modeling and structural simulation of the plaque and vessel wall. Ten patients were involved in our study. Starting with segmentation of the lumen, calcific and lipid plaque components from computed tomography angiography images, the fibrous component and the vessel wall were semi-automatically reconstructed with an ad-hoc procedure. Finite element analyses were performed using local pressure values derived from ultrasound imaging. Simulation outputs were analyzed to assess how mechanical factors influence the stresses within the atherosclerotic wall. The developed reconstruction method was first evaluated by comparing the results obtained using the automatically generated fibrous component model and the one derived from image segmentation. The high-stress regions in the carotid artery wall around plaques suggest areas of possible rupture. In mostly lipidic and heterogeneous plaques, the highest stresses are localized at the interface between the lipidic components and the lumen, in the fibrous cap.

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PMID: 39410608 PMC: 11476427. DOI: 10.3390/diagnostics14192204.

References

1.

Lee R, Grodzinsky A, Frank E, Kamm R, Schoen F . Structure-dependent dynamic mechanical behavior of fibrous caps from human atherosclerotic plaques. Circulation. 1991; 83(5):1764-70. DOI: 10.1161/01.cir.83.5.1764. View

2.

Holzapfel G, Sommer G, Regitnig P . Anisotropic mechanical properties of tissue components in human atherosclerotic plaques. J Biomech Eng. 2005; 126(5):657-65. DOI: 10.1115/1.1800557. View

3.

Gao H, Long Q . Effects of varied lipid core volume and fibrous cap thickness on stress distribution in carotid arterial plaques. J Biomech. 2008; 41(14):3053-9. DOI: 10.1016/j.jbiomech.2008.07.011. View

4.

Saba L, Anzidei M, Cavallo Marincola B, Piga M, Raz E, Bassareo P . Imaging of the carotid artery vulnerable plaque. Cardiovasc Intervent Radiol. 2013; 37(3):572-85. DOI: 10.1007/s00270-013-0711-2. View

5.

Chau A, Chan R, Shishkov M, MacNeill B, Iftimia N, Tearney G . Mechanical analysis of atherosclerotic plaques based on optical coherence tomography. Ann Biomed Eng. 2005; 32(11):1494-503. DOI: 10.1114/b:abme.0000049034.75368.4a. View

6.

Kang S, Ha H, Lee J, Han S, Mintz G, Kweon J . Plaque structural stress assessed by virtual histology-intravascular ultrasound predicts dynamic changes in phenotype and composition of untreated coronary artery lesions. Atherosclerosis. 2016; 254:85-92. DOI: 10.1016/j.atherosclerosis.2016.09.072. View

7.

Teng Z, Sadat U, Brown A, Gillard J . Plaque hemorrhage in carotid artery disease: pathogenesis, clinical and biomechanical considerations. J Biomech. 2014; 47(4):847-58. PMC: 3994507. DOI: 10.1016/j.jbiomech.2014.01.013. View

8.

Naim C, Douziech M, Therasse E, Robillard P, Giroux M, Arsenault F . Vulnerable atherosclerotic carotid plaque evaluation by ultrasound, computed tomography angiography, and magnetic resonance imaging: an overview. Can Assoc Radiol J. 2013; 65(3):275-86. DOI: 10.1016/j.carj.2013.05.003. View

9.

Yushkevich P, Piven J, Hazlett H, Smith R, Ho S, Gee J . User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage. 2006; 31(3):1116-28. DOI: 10.1016/j.neuroimage.2006.01.015. View

10.

Teng Z, Canton G, Yuan C, Ferguson M, Yang C, Huang X . 3D critical plaque wall stress is a better predictor of carotid plaque rupture sites than flow shear stress: An in vivo MRI-based 3D FSI study. J Biomech Eng. 2010; 132(3):031007. PMC: 2924579. DOI: 10.1115/1.4001028. View

11.

de Ruijter J, van Sambeek M, van de Vosse F, Lopata R . Automated 3D geometry segmentation of the healthy and diseased carotid artery in free-hand, probe tracked ultrasound images. Med Phys. 2019; 47(3):1034-1047. PMC: 7079173. DOI: 10.1002/mp.13960. View

12.

Barrett S, Sutcliffe M, Howarth S, Li Z, Gillard J . Experimental measurement of the mechanical properties of carotid atherothrombotic plaque fibrous cap. J Biomech. 2009; 42(11):1650-5. DOI: 10.1016/j.jbiomech.2009.04.025. View

13.

Banerjee C, Chimowitz M . Stroke Caused by Atherosclerosis of the Major Intracranial Arteries. Circ Res. 2017; 120(3):502-513. PMC: 5312775. DOI: 10.1161/CIRCRESAHA.116.308441. View

14.

Yeom E, Nam K, Jin C, Paeng D, Lee S . 3D reconstruction of a carotid bifurcation from 2D transversal ultrasound images. Ultrasonics. 2014; 54(8):2184-92. DOI: 10.1016/j.ultras.2014.06.002. View

15.

Kolos I, Troitskiy A, Balakhonova T, Shariya M, Skrypnik D, Tvorogova T . Modern medical treatment with or without carotid endarterectomy for severe asymptomatic carotid atherosclerosis. J Vasc Surg. 2015; 62(4):914-22. DOI: 10.1016/j.jvs.2015.05.005. View

16.

Sadat U, Teng Z, Young V, Walsh S, Li Z, Graves M . Association between biomechanical structural stresses of atherosclerotic carotid plaques and subsequent ischaemic cerebrovascular events--a longitudinal in vivo magnetic resonance imaging-based finite element study. Eur J Vasc Endovasc Surg. 2010; 40(4):485-91. DOI: 10.1016/j.ejvs.2010.07.015. View

17.

Naghavi M, Libby P, Falk E, Casscells S, Litovsky S, Rumberger J . From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation. 2003; 108(14):1664-72. DOI: 10.1161/01.CIR.0000087480.94275.97. View

18.

Yang J, Dou G, Tesche C, De Cecco C, Jacobs B, Schoepf U . Progression of coronary atherosclerotic plaque burden and relationship with adverse cardiovascular event in asymptomatic diabetic patients. BMC Cardiovasc Disord. 2019; 19(1):39. PMC: 6371483. DOI: 10.1186/s12872-019-1016-4. View

19.

Wang Y, Wang T, Luo Y, Jiao L . Identification Markers of Carotid Vulnerable Plaques: An Update. Biomolecules. 2022; 12(9). PMC: 9496377. DOI: 10.3390/biom12091192. View

20.

Kwak B, Back M, Bochaton-Piallat M, Caligiuri G, Daemen M, Davies P . Biomechanical factors in atherosclerosis: mechanisms and clinical implications. Eur Heart J. 2014; 35(43):3013-20, 3020a-3020d. PMC: 4810806. DOI: 10.1093/eurheartj/ehu353. View