Identification of atherosclerotic lesion-prone sites through patient-specific simulation of low-density lipoprotein accumulation

We present a patient-specific model of low-density lipoprotein (LDL) transport from blood into arterial walls. To this end, the arterial endothelium is represented by a shear-stress dependent three-pore model taking into account blood plasma and LDL passage through the vesicular pathway, normal junctions and leaky junctions. We virtually remove atherosclerotic plaque from an in-vivo left coronary artery computed tomography (CT) dataset to obtain an approximation of the artery anatomy in its healthy state. By applying our model, we show that the location of the plaque in the diseased state corresponds to one of the two sites with predicted high LDL concentration in the healthy state. We further show that in the diseased state, the site with high LDL concentration has shifted distally, which is in agreement with the clinical observation that plaques generally grow in downstream direction.