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Abstract #1036

In Vivo MRI-Based Patient-Specific Simulation of Fatigue Process: A Possible Trigger for Carotid Atherosclerotic Plaque Rupture

Yuan Huang1, Zhongzhao Teng1, 2, Umar Sadat, 13, Victoria E. Young1, Martin J. Graves1, Jonathan H. Gillard1

1Department of Radiology, University of Cambridge, Cambridge, United Kingdom; 2Department of Engineering, University of Cambridge, Cambridge, United Kingdom; 3Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge, United Kingdom

The traditional hypothesis that plaque rupture occurs when the external loading exceeds the fibrous cap strength has shown its limitations. In this study an alternative mechanism of rupture, material fatigue, was investigated based on in-vivo MR images. Slices with rupture and ulceration obtained from fourteen patients with carotid atherosclerotic disease were used for the simulation. Crack growth was quantified using modified Paris Law. The predicted crack initiations all matched with the in-vivo observation, and 12 /14 models showed the crack in accordance with in-vivo images. Further results showed the fatigue life decreased rapidly with smaller fibrous cap thickness.

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Keywords

accelerating accordance accumulated acute agents allows alone already animals anticoagulants arrow artery assessing asterisk background beat best blood carotid cause causing characterized cholesterol clinically coll component condition considerations crack cracks critical cycles damage decreased deformation depict developed development disease electrocardiograph element enclosed engineering events eventually exceeds experimental explored exponentially external fatigue fibrous finite flow fourteen gated good governed graves green heart helpful hospital human hypothesis hypothesized importance in vivo included indicated initiated initiations integration intrinsic kingdom length life linearly loading local located logarithm marked martin matched material mechanism medical model modeled modified natural needed nominal numerical observation occur occurs patient patients perpendicular plaque plaques predicted predominant presence pressure pressures principle process produce propagate propagation pulse quiescent radially radiology rapidly reach reached relation relationship repetitive reported required resolution risk rupture ruptures seemingly simulated simulation simulations site steps strength stress structure studies subjected subjects syndrome therapy thinner trigger ulceration unit vascular vulnerable white young yuan