A new imaging technique to study 3-D plaque and shear stress distribution in human coronary artery bifurcations in vivo

Frank J H Gijsen, Jolanda J. Wentzel, A. Thury, Bram Lamers, Johan C H Schuurbiers, Patrick W. Serruys, Antonius F. van der Steen

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: Bifurcations of coronary arteries are predilection sites for atherosclerosis and expansive remodeling, the latter being associated with plaque vulnerability. Both are related to blood flow-induced shear stress (SS). We present a new approach to generate 3-D reconstructions of coronary artery bifurcations in vivo and investigate the relationship between SS, wall thickness (WT) and remodeling. Methods: The patient specific 3-D reconstruction of the main branch of the bifurcation was obtained by combining intravascular ultrasound and biplane angiography, and the 3-D lumen of the side branch was based on biplane angiography only. The two data sets were fused and computational methods were applied to determine the SS distribution, using patient derived flow and viscosity data. The intravascular ultrasound data allowed us to measure local WT and remodeling in the main branch. Results: The lumen reconstruction procedure was successful and it was shown that the impact of the side branch on SS distribution in the main branch diminished within 3 mm. Distal to the bifurcation, two continuous regions in the main branch were identified. In the proximal region, we observed lumen preservation, and expansive remodeling. Although a plaque was observed in the low SS region at the non-divider wall, no relationship between SS and WT was found. In the distal region, we observed lumen narrowing and a significant positive relationship between SS and WT. Conclusions: A new imaging technique was applied to generate a 3-D reconstruction of a human coronary artery bifurcation in vivo. The observed relationship between SS, WT and remodeling in this specific patient illustrates the spatial heterogeneity of the atherosclerosis in the vicinity of arterial bifurcations.

Original languageEnglish
Pages (from-to)2349-2357
Number of pages9
JournalJournal of Biomechanics
Volume40
Issue number11
DOIs
Publication statusPublished - 2007

Fingerprint

Stress concentration
Shear stress
Coronary Vessels
Imaging techniques
Atherosclerosis
Angiography
Viscosity
Shear walls
Ultrasonics
Computational methods
Blood
Datasets

Keywords

  • Atherosclerosis
  • Coronary bifurcation
  • Hemodynamics
  • Imaging
  • Shear stress

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Gijsen, F. J. H., Wentzel, J. J., Thury, A., Lamers, B., Schuurbiers, J. C. H., Serruys, P. W., & van der Steen, A. F. (2007). A new imaging technique to study 3-D plaque and shear stress distribution in human coronary artery bifurcations in vivo. Journal of Biomechanics, 40(11), 2349-2357. https://doi.org/10.1016/j.jbiomech.2006.12.007

A new imaging technique to study 3-D plaque and shear stress distribution in human coronary artery bifurcations in vivo. / Gijsen, Frank J H; Wentzel, Jolanda J.; Thury, A.; Lamers, Bram; Schuurbiers, Johan C H; Serruys, Patrick W.; van der Steen, Antonius F.

In: Journal of Biomechanics, Vol. 40, No. 11, 2007, p. 2349-2357.

Research output: Contribution to journalArticle

Gijsen, Frank J H ; Wentzel, Jolanda J. ; Thury, A. ; Lamers, Bram ; Schuurbiers, Johan C H ; Serruys, Patrick W. ; van der Steen, Antonius F. / A new imaging technique to study 3-D plaque and shear stress distribution in human coronary artery bifurcations in vivo. In: Journal of Biomechanics. 2007 ; Vol. 40, No. 11. pp. 2349-2357.
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AU - Thury, A.

AU - Lamers, Bram

AU - Schuurbiers, Johan C H

AU - Serruys, Patrick W.

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AB - Objective: Bifurcations of coronary arteries are predilection sites for atherosclerosis and expansive remodeling, the latter being associated with plaque vulnerability. Both are related to blood flow-induced shear stress (SS). We present a new approach to generate 3-D reconstructions of coronary artery bifurcations in vivo and investigate the relationship between SS, wall thickness (WT) and remodeling. Methods: The patient specific 3-D reconstruction of the main branch of the bifurcation was obtained by combining intravascular ultrasound and biplane angiography, and the 3-D lumen of the side branch was based on biplane angiography only. The two data sets were fused and computational methods were applied to determine the SS distribution, using patient derived flow and viscosity data. The intravascular ultrasound data allowed us to measure local WT and remodeling in the main branch. Results: The lumen reconstruction procedure was successful and it was shown that the impact of the side branch on SS distribution in the main branch diminished within 3 mm. Distal to the bifurcation, two continuous regions in the main branch were identified. In the proximal region, we observed lumen preservation, and expansive remodeling. Although a plaque was observed in the low SS region at the non-divider wall, no relationship between SS and WT was found. In the distal region, we observed lumen narrowing and a significant positive relationship between SS and WT. Conclusions: A new imaging technique was applied to generate a 3-D reconstruction of a human coronary artery bifurcation in vivo. The observed relationship between SS, WT and remodeling in this specific patient illustrates the spatial heterogeneity of the atherosclerosis in the vicinity of arterial bifurcations.

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