NDLI: Changing Views of the Biomechanics of Vulnerable Plaque Rupture: A Review

Content Provider	Springer Nature Link
Author	Cardoso, Luis Weinbaum, Sheldon
Copyright Year	2013
Abstract	This review examines changing perspectives on the biomechanics of vulnerable plaque rupture over the past 25 years from the first finite element analyses (FEA) showing that the presence of a lipid pool significantly increases the local tissue stress in the atheroma cap to the latest imaging and 3D FEA studies revealing numerous microcalcifications in the cap proper and a new paradigm for cap rupture. The first part of the review summarizes studies describing the role of the fibrous cap thickness, tissue properties, and lesion geometry as main determinants of the risk of rupture. Advantages and limitations of current imaging technologies for assessment of vulnerable plaques are also discussed. However, the basic paradoxes as to why ruptures frequently did not coincide with location of PCS and why caps >65 μm thickness could rupture at tissue stresses significantly below the 300 kPa critical threshold still remained unresolved. The second part of the review describes recent studies in the role of microcalcifications, their origin, shape, and clustering in explaining these unresolved issues including the actual mechanism of rupture due to the explosive growth of tiny voids (cavitation) in local regions of high stress concentration between closely spaced microinclusions oriented along their tensile axis.
Starting Page	415
Ending Page	431
Page Count	17
File Format	PDF
ISSN	00906964
Journal	Annals of Biomedical Engineering
Volume Number	42
Issue Number	2
e-ISSN	15739686
Language	English
Publisher	Springer US
Publisher Date	2013-07-11
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Human atheroma Biomechanics of rupture Vulnerable plaque Fibrous cap Microcalcification hypothesis Biomedicine general Biomedical Engineering Biophysics and Biological Physics Mechanics Biochemistry
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering

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