Document Detail

Stratification of risk in thin cap fibroatheromas using peak plaque stress estimates from idealized finite element models.
MedLine Citation:
PMID:  22342558     Owner:  NLM     Status:  Publisher    
Thin cap fibroatheroma (TCFA) in coronary arteries is believed to be associated with plaque rupture leading to cardiovascular death and non-fatal myocardial infarction. Catheter-based imaging platforms can identify TCFAs but detection algorithms lack specificity. Here we report results of an exploratory study of the variability in TCFA plaque attributes and effects on peak von Mises stress of TCFA using idealized finite element models. A total of 1272 idealized TCFA finite element models were developed by strategically varying attribute dimensions - external elastic membrane diameter, lumen diameter, necrotic core thickness, fibrous cap thickness, and necrotic core angle - obtained from a global registry of subjects undergoing percutaneous coronary intervention with Virtual Histology intravascular ultrasound. Peak stress exhibited parabolic or higher order proportionality with lumen diameter, sigmoidal proportionality with necrotic core thickness, inverse hyperbolic proportionality with fibrous cap thickness, and skewed sinusoidal proportionality with necrotic core angle. Each of these relationships was governed by highly sensitive, complex, and interdependent influences of various attributes on plaque stress. An over 7-fold increase in peak stress from 101 to 788kPa was observed in models of coronary dimensions commonly encountered in clinical practice. Peak stress of intramural TCFA within this common coronary artery subset did not exceed 300kPa for fibrous cap thickness greater than 100μm and necrotic core angle outside 90-120° range, indicating low risk of rupture. This exploratory study demonstrated the complex and interdependent influence of plaque attributes on the peak stress of TCFA.
William Jacob S Dolla; John A House; Steven P Marso
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-16
Journal Detail:
Title:  Medical engineering & physics     Volume:  -     ISSN:  1873-4030     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422753     Medline TA:  Med Eng Phys     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.
Saint Luke's Mid America Heart Institute, Kansas City, MO, United States.
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