Key result
Increasing carotid artery stenosis from mild to severe significantly increased the effective, circumferential, and first principal stresses at the plaque throat by 97%, 74%, and 103%, respectively.
Why the study?
This study evaluated the accuracy of models reconstructed from ultrasound image processing and examined plaque stress changes depending on the degree of carotid artery stenosis.
Cross-Sectional (n=14)
No
Subject-specific finite element models reconstructed from in vivo ultrasonography can accurately discriminate differences in mechanical stresses applied to mildly and severely stenotic carotid plaques.
Answers are grounded in this paper and cite their sources.
Ultrasonography-based finite element models differentiate plaque stresses by stenosis severity; leaves open their added value for clinical risk stratification.
PURPOSE: This study investigated the accuracy of models reconstructed from ultrasound image processing by comparing the radial displacement waveforms of a subject-specific artery model and evaluated stress changes in the proximal shoulder, throat, and distal shoulder of the plaques depending on the degree of carotid artery stenosis. METHODS: Three groups of subjects (healthy and with less than 50% or more carotid stenosis) were evaluated with ultrasonography. Two-dimensional transverse imaging of the common carotid artery was performed to reconstruct the geometry. A longitudinal view of the same region was recorded to extract the Kelvin viscoelastic model parameters. The pulse pressure waveform and the effective pressure of perivascular tissue were loaded onto the internal and external walls of the model. Effective, circumferential, and principal stresses applied to the plaque throat, proximal shoulder, and distal shoulder in the transverse planes were extracted. RESULTS: The radial displacement waveforms of the model were closely correlated with those of image processing in all three groups. The mean of the effective, circumferential, and principal stresses of the healthy arteries were 15.01±4.93, 12.97±5.07, and 12.39±2.86 kPa, respectively. As stenosis increased from mild to significant, the mean values of the effective, circumferential, and first principal stresses increased significantly (97%, 74%, and 103% at the plaque throat, respectively) (P<0.05). The minimum effective stress was at the lipid pool. The effective stress in calcified areas was higher than in other parts of the artery wall. CONCLUSION: This model can discriminate differences in stresses applied to mildly and severely stenotic plaques.
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Soleimani et al. (2021) conducted a cross-sectional in Carotid artery stenosis (n=14). Severe (≥50%) carotid artery stenosis vs. Mild (<50%) carotid artery stenosis was evaluated on Effective stress at the plaque throat (97% increase, p=0.049). Increasing carotid artery stenosis from mild to severe significantly increased the effective, circumferential, and first principal stresses at the plaque throat by 97%, 74%, and 103%, respectively.
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