Document Detail

Modeling plaque fissuring and dissection during balloon angioplasty intervention.
MedLine Citation:
PMID:  17385047     Owner:  NLM     Status:  MEDLINE    
Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and/or dissection occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment site. We propose physical and finite element models, which are generally useable to trace fissuring and/or dissection in atherosclerotic plaques during balloon angioplasty interventions. The arterial wall is described as an anisotropic, heterogeneous, highly deformable, nearly incompressible body, whereas tissue failure is captured by a strong discontinuity kinematics and a novel cohesive zone model. The numerical implementation is based on the partition of unity finite element method and the interface element method. The later is used to link together meshes of the different tissue components. The balloon angioplasty-based failure mechanisms are numerically studied in 3D by means of an atherosclerotic-prone human external iliac artery, with a type V lesion. Image-based 3D geometry is generated and tissue-specific material properties are considered. Numerical results show that in a primary phase the plaque fissures at both shoulders of the fibrous cap and stops at the lamina elastica interna. In a secondary phase, local dissections between the intima and the media develop at the fibrous cap location with the smallest thickness. The predicted results indicate that plaque fissuring and dissection cause localized mechanical trauma, but prevent the main portion of the stenosis from high stress, and hence from continuous tissue damage.
T Christian Gasser; Gerhard A Holzapfel
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-24
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  35     ISSN:  0090-6964     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-18     Completed Date:  2007-06-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  711-23     Citation Subset:  IM    
Department of Solid Mechanics, School of Engineering Sciences, Royal Institute of Technology (KTH), Osquars Backe 1, SE-100 44, Stockholm, Sweden.
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MeSH Terms
Aneurysm, Dissecting / etiology*,  physiopathology*
Angioplasty, Balloon / adverse effects*
Atherosclerosis / etiology*,  physiopathology*
Computer Simulation
Iliac Artery / injuries,  physiopathology*
Models, Cardiovascular*

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