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The Journal of Cardiovascular Surgery 2022 Sep 14

DOI: 10.23736/S0021-9509.22.12170-1


language: English

Fluid structure interaction analysis to stratify the behavior of different atheromatous carotid plaques

Maurizio DOMANIN 1, 2 , Lorenzo BENNATI 3, Christian VERGARA 4, Daniele BISSACCO 1, Chiara MALLOGGI 5, Vincenzo SILANI 5, 6, Gianfranco PARATI 7, 8, Santi TRIMARCHI 1, 2, Renato CASANA 9, 10

1 Dipartimento di Scienze Cliniche e di COmunità (DISCCO), University of Milan, Milan, Italy; 2 Unit of Vascular Surgery, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; 3 Department of Odontostomatologic and Mother-Child Surgical Sciences, University of Verona, Verona, Italy; 4 LABS, Giulio Natta Department of Chemistry, Materials and Chemical Engineering, Polytechnic of Milan, Milan, Italy; 5 Laboratory of Neurologic Sciences, Department of Neurology and Stroke Unit, Italian Auxologic IRCCS Institute, San Luca Hospital, Milan, Italy; 6 Department of Medico-Surgical and Transplantation Physiopathology, Dino Ferrari Center, University of Milan, Milan, Italy; 7 Department of Cardiovascular, Neurologica and Metabolic Sciences, Italian Auxologic IRCCS Institute, San Luca Hospital, Milan, Italy; 8 Department of Medicine and Surgery, Milan-Bicocca University, Milan, Italy; 9 Capitanio Vascular Surgery Auxologic Center, Italian Auxologic IRCCS Institute, Milan, Italy; 10 Experimental Laboratory of Vascular Surgery Research, Italian Auxologic IRCCS Institute, Milan, Italy


BACKGROUND: In asymptomatic carotid stenosis (ACS), different plaque types, i.e. lipidic (LP), fibrous (FP), and calcific (CP), could have different hemodynamic and structural behaviors.
METHODS: Different carotid plaques, reconstructed from medical imaging of ACS >70%, were analyzed by computing fluid structure interaction (FSI), modeling the spatial distribution of wall shear stresses (WSS), plaque displacements (D), von Mises stresses (VMS), and absorbed elastic energy (AEE) together with their maximum-in-space values at the systole (WSSsyst, Dsyst, VMSsyst and AEEsyst).
RESULTS: WSS resulted significantly higher in CP, whereas D and VMS showed the highest values for LP. Regarding AEEsyst stored by the plaques, LP absorbed in average 2320 J/m3, FP 408 J/m3 (470%) and CP 99 J/m3 (2240%), (P < 0.01, P < 0.01, and P < 0.01, respectively).
CONCLUSIONS: Depending upon their nature, plaques store different deformations and inner distributions of forces, thus potentially influencing their vulnerability.

KEY WORDS: Carotid stenosis; Carotid plaque; Carotid endarterectomy; Computational fluid dynamics; Fluid structure interaction; Risk stratification

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