Investigation of the significance of the plaque morphology evolution in plaque rupture events using computational biomechanics

Forwarded by the technological urge of this era, several computational methods are implemented to give further insights into possible outcomes of diseases. In this context, atherosclerosis, which is one of the most fatal diseases nowadays, is treated alike, where several computational models are proposed annually allowing for the evaluation of several outcomes for patient specific cases. Among them, one of the most significant models is able to predict the atherosclerotic evolution over time. In this proof-of-concept study, we aim to investigate the effect of plaque morphology on plaque rupture in a two-case scenario - a longitudinal and a bulk plaque evolution in 3D-reconstructed patient-specific carotids arteries. Our approach is based on a three-step process: i) the implementation of a state-of-the-art plaque growth model that predicts evolving and new plaques in real patient specific carotid arteries, ii) the selection of 2 patient cases, one with longitudinal plaque evolution and one with bulk plaque evolution and, finally, iii) the evaluation the maximum principal stress over the plaques and the endothelium layers to assess the plaque rupture risk. The results indicate that the evolving plaques towards the lumen, not only cause stenoses but also are more prone to rupture. Clinical relevance- This proof-of-concept work establishes that the plaques that grow towards the luminal border present with a higher risk of potential rupture compared to plaques that grow longitudinally, thus giving valuable insights to clinicians for important decision making regarding potential endarterectomy procedures.