Key result
Maximum wall shear stress around eccentric longitudinal asymmetrical plaques was 8.6 times larger than eccentric plaques and 1.9 times larger than concentric plaques.
Why the study?
The effect of symmetrical features of carotid atherosclerotic plaques, particularly longitudinal asymmetrical characteristics, on disturbed hemodynamic environments had not been comparatively studied.
How do different symmetrical features of carotid atherosclerotic plaques affect hemodynamic environments such as wall shear stress?
Observational (n=4)
How do different symmetrical features of carotid atherosclerotic plaques affect hemodynamic environments such as wall shear stress?
Effect estimate: 8.6 times larger than eccentric plaque
Eccentric longitudinal asymmetrical carotid plaques create highly disordered hemodynamic environments with significantly elevated wall shear stress, potentially increasing the risk of plaque progression and rupture.
Higher shear stress around asymmetrical plaques is hypothesis-generating; prospective studies needed before clinical risk stratification.
Atherosclerotic plaque near the carotid sinus is a key risk factor for ischemic stroke. Although disturbed hemodynamic environments around atherosclerotic plaque had been investigated in many studies, the effect of their symmetrical features, especially longitudinal asymmetrical characteristics, had not been comparatively studied. In this study, three-dimensional carotid bifurcation models were established based on CT images of three patients with 50% stenosis and with different symmetrical features of carotid atherosclerotic plaques including concentric plaque, eccentric plaque, or eccentric longitudinal asymmetrical plaque. A healthy subject was chosen as the control. Wall shear stress (WSS) and oscillating shear index in the regions of upstream, downstream, downstream shoulders and regions around the point of maximum stenosis were analyzed. The results indicated that the maximum WSS around the eccentric longitudinal asymmetrical plaque were 8.6 times larger than that of the eccentric plaque and 1.9 times larger than that of the concentric plaque. And the distributions of WSS and OSI around the eccentric longitudinal asymmetric plaque were more disordered than those of the others. Our results highlighted the risk of the eccentric longitudinal asymmetrical plaque on plaque development and rupture and might provide a new index for evaluating the development of atherosclerosis.
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Gong et al. (2021) conducted an observational in Carotid atherosclerotic plaques (n=4). Eccentric longitudinal asymmetrical plaque vs. Eccentric plaque and concentric plaque was evaluated on Maximum wall shear stress (WSS) (8.6 times larger than eccentric plaque). Maximum wall shear stress around eccentric longitudinal asymmetrical plaques was 8.6 times larger than eccentric plaques and 1.9 times larger than concentric plaques.
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