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Increased Proximal Wall Shear Stress of Basilar Artery Plaques Associated with Ruptured Fibrous Cap

Ruiyun Huang1, Hongbing Chen2, Chenghao Li3

  • 1Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang East Road, Guangzhou 510260, China.

Brain Sciences
|October 27, 2022
PubMed

Insights

Fluid dynamics influence basilar artery plaque rupture, a key cause of stroke. Increased wall shear stress in stenosis is linked to ruptured fibrous caps, indicating higher stroke risk.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Biomedical Engineering

Background:

  • Basilar artery plaque rupture is a primary cause of posterior circulation stroke.
  • Understanding the biomechanical factors contributing to plaque rupture is crucial for stroke prevention.

Purpose of the Study:

  • To investigate the role of fluid dynamics, specifically wall shear stress, in the rupture of basilar artery plaques.
  • To identify the relationship between stenosis characteristics and fibrous cap integrity.

Main Methods:

  • Screening of patients with basilar artery plaques (50-99% stenosis).
  • High-resolution MRI for fibrous cap integrity assessment.
  • Computational fluid dynamics (CFD) modeling based on MR angiography to determine wall shear stress and velocity.

Main Results:

  • 35 ruptured fibrous caps identified among 176 patients.
  • Ruptured fibrous caps were significantly associated with acute infarction in the basilar artery territory (p < 0.05).
  • Proximal wall shear stress of stenosis showed a positive correlation with ruptured fibrous caps (OR 1.564, p = 0.013), with a threshold of 4.84 Pa.

Conclusions:

  • Increased proximal wall shear stress is associated with ruptured fibrous caps in basilar artery plaques.
  • Fluid dynamics play a significant role in the pathogenesis of posterior circulation stroke.
  • Wall shear stress may serve as a predictive biomarker for basilar artery plaque rupture.

Keywords:
basilar arterycomputational fluid dynamicshigh resolution MRIrupture of fibrous capwall shear stress

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