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Updated: Aug 30, 2025
A Method to Study the Correlation Between Local Collagen Structure and Mechanical Properties of Atherosclerotic Plaque Fibrous Tissue
Published on: November 11, 2022
Patient-specific biomechanical analysis of atherosclerotic plaques enabled by histologically validated tissue
Andrew J Buckler1, Max van Wanrooij2, Måns Andersson2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Elucid Bioimaging Inc., Boston, MA, United States.
Insights
This study introduces a new method to assess individual atherosclerotic plaque rupture risk non-invasively. Patient-specific biomechanical analysis can identify high-risk plaques, potentially preventing myocardial infarction and stroke.
Area of Science:
- Cardiovascular Disease Research
- Biomedical Engineering
- Medical Imaging Analysis
Background:
- Atherosclerotic plaque rupture, characterized by a large lipid-rich necrotic core and thin fibrous cap, is a primary cause of myocardial infarction and stroke.
- Current clinical assessments rely on luminal narrowing, an inadequate predictor of plaque instability.
- Effective methods for assessing individual patient plaque rupture risk are lacking.
Purpose of the Study:
- To demonstrate a novel, non-invasive method for assessing biomechanical indices related to atherosclerotic plaque rupture risk in individual patients.
- To validate the use of histological data for tissue characterization in plaque analysis.
- To provide a tool for personalized risk assessment and treatment decisions.
Main Methods:
- Routinely acquired clinical plaque images were analyzed using histology-validated software (ElucidVivo) for vascular wall tissue characterization.
- Wall stress and strain were calculated at varying fibrous cap thicknesses under different blood pressure conditions.
- Biomechanical indices were computed based on tissue distribution derived from imaging.
Main Results:
- Calculated von Mises stress and equivalent strain at the thinnest fibrous cap location (560 μm) indicated a risk of plaque failure (152 [131, 172] kPa and 0.10 [0.08, 0.12], respectively).
- Stress and strain values were lower at thicker cap locations, demonstrating a clinically relevant range of risk levels.
- Patient-specific tissue characterization revealed distributions of stress and strain.
Conclusions:
- Patient-specific tissue characterization non-invasively identifies stress and strain distributions within a clinically relevant range.
- This approach can identify high-risk atherosclerotic plaques.
- Personalized risk assessment may improve cardiovascular disease treatment and prevention of myocardial infarction and stroke.
Background:
Rupture of unstable atherosclerotic plaques with a large lipid-rich necrotic core and a thin fibrous cap cause myocardial infarction and stroke. Yet it has not been possible to assess this for individual patients. Clinical guidelines still rely on use of luminal narrowing, a poor indicator but one that persists for lack of effective means to do better. We present a case study demonstrating the assessment of biomechanical indices pertaining to plaque rupture risk non-invasively for individual patients enabled by histologically validated tissue characterization.
Methods:
Routinely acquired clinical images of plaques were analyzed to characterize vascular wall tissues using software validated by histology (ElucidVivo, Elucid Bioimaging Inc.). Based on the tissue distribution, wall stress and strain were then calculated at spatial locations with varied fibrous cap thicknesses at diastolic, mean and systolic blood pressures.
Results:
The von Mises stress of 152 [131, 172] kPa and the equivalent strain of 0.10 [0.08, 0.12] were calculated where the fibrous cap thickness was smallest (560 μm) (95% CI in brackets). The stress at this location was at a level predictive of plaque failure. Stress and strain at locations with larger cap thicknesses were calculated to be lower, demonstrating a clinically relevant range of risk levels.
Conclusion:
Patient specific tissue characterization can identify distributions of stress and strain in a clinically relevant range. This capability may be used to identify high-risk lesions and personalize treatment decisions for individual patients with cardiovascular disease and improve prevention of myocardial infarction and stroke.
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