title: Effect of calcification on the mechanical stability of plaque based on a three-dimensional carotid bifurcation model.
abstract: BACKGROUND
  This study characterizes the distribution and components of plaque structure by presenting a three-dimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque.
  
  
  METHODS
  Modelling atherosclerotic plaque based on structural analysis confirms the rationale for plaque mechanical examination and the feasibility of our simulation model. Meaningful validation of predictions from modelled atherosclerotic plaque model typically requires examination of bona fide atherosclerotic lesions. To analyze a more accurate plaque rupture, fluid-structure interaction is applied to three-dimensional blood-vessel carotid bifurcation modelling. A patient-specific pressure variation is applied onto the plaque to influence its vulnerability.
  
  
  RESULTS
  Modelling of the human atherosclerotic artery with varying degrees of lipid core elasticity, fibrous cap thickness and calcification gap, which is defined as the distance between the fibrous cap and calcification agglomerate, form the basis of our rupture analysis. Finite element analysis shows that the calcification gap should be conservatively smaller than its threshold to maintain plaque stability. The results add new mechanistic insights and methodologically sound data to investigate plaque rupture mechanics.
  
  
  CONCLUSIONS
  Structural analysis using a three-dimensional calcified model represents a more realistic simulation of late-stage atherosclerotic plaque. We also demonstrate that increases of calcium content that is coupled with a decrease in lipid core volume can stabilize plaque structurally.
authors.affiliation: School of Aerospace, Mechanical and Manufacturing Engineering, and Health Innovations Research Institute (HIRi), RMIT University, Australia.
authors.forename: Kelvin Kl
authors.initials: KK
authors.lastname: Wong
authors.forename: Pongpat
authors.initials: P
authors.lastname: Thavornpattanapong
authors.forename: Sherman Cp
authors.initials: SC
authors.lastname: Cheung
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Sun
authors.forename: Jiyuan
authors.initials: J
authors.lastname: Tu
mesh_terms: D050197:Atherosclerosis / Q000473:pathology* / Q000503:physiopathology; D002114:Calcinosis / Q000473:pathology* / Q000503:physiopathology; D002339:Carotid Arteries / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000473:pathology* / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000473:pathology; D016893:Carotid Stenosis / Q000473:pathology; D003198:Computer Simulation; D004548:Elasticity / Q000502:physiology; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D050356:Lipid Metabolism; D008955:Models, Cardiovascular; D008962:Models, Theoretical; D058226:Plaque, Atherosclerotic / Q000473:pathology* / Q000503:physiopathology; D013314:Stress, Mechanical