Stress analysis using anatomically realistic coronary tree

Area of Science:

• Cardiovascular research
• Biomechanical engineering
• Medical imaging analysis

Background:

• Plaque rupture in coronary arteries causes acute coronary syndromes.
• Mechanical fatigue from cyclic plaque flexion may lead to endothelial disruption and rupture.
• Current methods for assessing plaque vulnerability are limited.

Purpose of the Study:

• To propose and validate a novel method for assessing stress and strain distribution in coronary plaques.
• To correlate plaque characteristics with mechanical stress using patient-specific models.
• To identify key factors contributing to plaque rupture risk.

Main Methods:

• Utilized finite element (FE) analysis for stress and strain distribution assessment.
• Reconstructed dynamic 3D coronary arterial trees in vivo from cine angiographic images.
• Modeled diseased arterial walls with fibrotic caps subjected to cyclic flexion from cardiac contraction.

Main Results:

• FEA simulations quantified local stresses on the diseased arterial wall.
• Identified smaller vessel diameter, greater percentage narrowing, and larger lesion size as factors increasing plaque cap stress.
• Determined vessel diameter to be the dominant factor influencing plaque cap stress.

Conclusions:

• The proposed FEA method provides a novel approach to assess coronary plaque stress.
• Patient-specific biomechanical modeling can identify high-risk plaques.
• Vessel diameter is a critical determinant of plaque rupture risk in coronary arteries.