Artery Research

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Volume 4, Issue 2, June 2010, Pages 59 - 65

Combined imaging, computational and histological analysis of a ruptured carotid plaque: A patient-specific analysis

Authors
Giulia Solopertoa, Niall G. Keenanb, Mary N. Sheppardc, Jacques Ohayond, Nigel B. Wooda, *, Dudley J. Pennellb, Raad H. Mohiaddinb, Xiao Yun Xua
aDepartment of Chemical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
bCardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield Trust, London, UK
cDepartment of Pathology, National Heart and Lung Institute, Imperial College London, UK
dEngineering School Polytech Savoie, University of Savoie, France
*Corresponding author. Tel.: +44 20 7594 5588; fax: +44 20 75941989. E-mail address: n.wood@imperial.ac.uk (N.B. Wood).
Corresponding Author
Nigel B. Wood
Received 8 April 2010, Revised 4 May 2010, Accepted 7 May 2010, Available Online 23 June 2010.
DOI
10.1016/j.artres.2010.05.001How to use a DOI?
Keywords
Carotid stenosis; MRI; Computational biomechanics; Computational haemodynamics; Plaque rupture
Abstract

Background: Rupture of carotid plaques is an important cause of cerebrovascular events. Several factors, including wall shear stress (WSS), plaque morphology and peak cap stress, have been associated with plaque vulnerability. The aim of this study was to investigate the relationship between these factors in an in vivo human ruptured carotid plaque.

Methods: A 74-year-old male presenting with a transient ischemic attack underwent carotid magnetic resonance imaging (MRI), which indicated a ruptured plaque, followed by carotid endarterectomy, from which plaque histology was assessed. The carotid bifurcation was reconstructed from the MRI data, and three-dimensional flow simulations were performed using computational fluid dynamics to determine WSS and related parameters. Plaque vulnerability was assessed using a biomechanical method based on modified Glagov criteria.

Results: The plaque rupture was just distal to the site of maximum stenosis in a region of low WSS, where MRI and histology both demonstrated fibrous cap thinning, a large lipid pool and calcification in the shoulder region. Plaque vulnerability analysis indicated critically vulnerable plaque at the rupture site by a wide margin.

Conclusions: Both low and high WSS have been associated with plaque vulnerability, and high mechanical stress in the cap has been linked to plaque rupture, but these parameters are not routinely assessed clinically. This study demonstrates a complete analysis by combining imaging, histology and bio-fluid and biomechanical modelling.

Copyright
© 2010 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

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<Previous Article In Issue
Journal
Artery Research
Volume-Issue
4 - 2
Pages
59 - 65
Publication Date
2010/06/23
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2010.05.001How to use a DOI?
Copyright
© 2010 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Giulia Soloperto
AU  - Niall G. Keenan
AU  - Mary N. Sheppard
AU  - Jacques Ohayon
AU  - Nigel B. Wood
AU  - Dudley J. Pennell
AU  - Raad H. Mohiaddin
AU  - Xiao Yun Xu
PY  - 2010
DA  - 2010/06/23
TI  - Combined imaging, computational and histological analysis of a ruptured carotid plaque: A patient-specific analysis
JO  - Artery Research
SP  - 59
EP  - 65
VL  - 4
IS  - 2
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2010.05.001
DO  - 10.1016/j.artres.2010.05.001
ID  - Soloperto2010
ER  -