TY - JOUR
T1 - On the Impact of Residual Strains in the Stress Analysis of Patient-Specific Atherosclerotic Carotid Vessels
T2 - Predictions Based on the Homogenous Stress Hypothesis
AU - Mastrofini, Alessandro
AU - Marino, Michele
AU - Karlöf, Eva
AU - Hedin, Ulf
AU - Gasser, T. Christian
PY - 2024/5
Y1 - 2024/5
N2 - The identification of carotid atherosclerotic lesion at risk for plaque rupture, eventually resulting in cerebral embolism and stroke, is of paramount clinical importance. High stress in the fibrous plaque cap has been proposed as risk factor. However, among others, residual strains influence said stress predictions, but quantitative and qualitative implications of residual strains in this context are not well explored. We therefore propose a multiplicative kinematics-based Growth and Remodeling (G&R) framework to predict residual strains from homogenizing tissue stress and then investigate its implication on plaque stress. Carotid vessel morphology of four patients was reconstructed from clinical Computed Tomography-Angiography (CT-A) images and equipped with heterogeneous tissue constitutive properties assigned through a histology-based artificial intelligence image segmentation tool. As compared to a purely elastic analysis and depending on patient-specific morphology and tissue distributions, the incorporation of residual strains reduced the maximum wall stress by up to 30% and resulted in a fundamentally different distribution of stress across the atherosclerotic wall. Regardless residual strains homogenized tissue stresses, the fibrous plaque cap may persistently be exposed to spots of high stress. In conclusion, the incorporation of residual strains in biomechanical studies of atherosclerotic carotids may be important for a reliable assessment of fibrous plaque cap stress.
AB - The identification of carotid atherosclerotic lesion at risk for plaque rupture, eventually resulting in cerebral embolism and stroke, is of paramount clinical importance. High stress in the fibrous plaque cap has been proposed as risk factor. However, among others, residual strains influence said stress predictions, but quantitative and qualitative implications of residual strains in this context are not well explored. We therefore propose a multiplicative kinematics-based Growth and Remodeling (G&R) framework to predict residual strains from homogenizing tissue stress and then investigate its implication on plaque stress. Carotid vessel morphology of four patients was reconstructed from clinical Computed Tomography-Angiography (CT-A) images and equipped with heterogeneous tissue constitutive properties assigned through a histology-based artificial intelligence image segmentation tool. As compared to a purely elastic analysis and depending on patient-specific morphology and tissue distributions, the incorporation of residual strains reduced the maximum wall stress by up to 30% and resulted in a fundamentally different distribution of stress across the atherosclerotic wall. Regardless residual strains homogenized tissue stresses, the fibrous plaque cap may persistently be exposed to spots of high stress. In conclusion, the incorporation of residual strains in biomechanical studies of atherosclerotic carotids may be important for a reliable assessment of fibrous plaque cap stress.
KW - Atherosclerotic disease
KW - Computational biomechanics
KW - Growth & remodeling
KW - Plaque rupture risk
KW - Tissue stress
KW - Plaque, Atherosclerotic/diagnostic imaging
KW - Artificial Intelligence
KW - Humans
KW - Stress, Mechanical
KW - Carotid Arteries/diagnostic imaging
KW - Stroke/pathology
KW - Fibrosis
KW - Atherosclerosis/diagnostic imaging
U2 - 10.1007/s10439-024-03458-4
DO - 10.1007/s10439-024-03458-4
M3 - Journal article
C2 - 38349443
AN - SCOPUS:85184935455
SN - 0090-6964
VL - 52
SP - 1347
EP - 1358
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 5
ER -