Key result
Unstable plaque models show greater pressure drops, higher shear, and shorter fatigue life than stable plaques.
Computational fluid-structure interaction modeling demonstrates that unstable atherosclerotic plaques experience worse hemodynamic stress, including higher oscillatory shear index and shorter fatigue life, compared to stable plaques.
Simulation data on plaque vulnerability should not guide practice; leaves open in vivo validation against clinical events.
Atherosclerotic plaques are the main cause of arterial stenosis. In this study, we construct stenosis models for both stable and unstable plaques, compare and analyze the hemodynamic impacts of these two plaques and explore their fatigue lifetimes at a 60% degree of stenosis. The assumptions of the idealized models and the fluid-structure interaction technique are used. The novelty of this work is to perform the stratified and refined simulation of atherosclerotic plaques. The results demonstrate that unstable plaque has a more pronounced pressure drop at the stenosis in contrast to stable plaque. It also exhibits a higher oscillatory shear index (OSI), a longer particle relative residence time (RRT), and a shorter fatigue life. The findings are that a thicker fibrous cap and a certain degree of calcification in the stable plaque can effectively carry the flow pressure and wall shear stress (WSS), thereby reducing the risk of plaque rupture. However, turbulence and flow separation phenomena are more likely to form in the unstable plaque model, with significant increases in instantaneous WSS, OSI and RRT. Thus, the integrity of the fiber cap structure is disrupted and the plaque structure is more fragile.
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Gao et al. (2026) studied Atherosclerotic plaques. Unstable plaque model vs. Stable plaque model was evaluated on Hemodynamic impacts (pressure drop, oscillatory shear index, relative residence time, fatigue life). Unstable atherosclerotic plaque models exhibited a more pronounced pressure drop, higher oscillatory shear index, longer particle relative residence time, and shorter fatigue life than stable plaques.
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