Optical coherence tomography-based patient-specific coronary artery reconstruction and fluid–structure interaction simulation

Plaque rupture is related to the mechanical stress it suffered. The value and distribution of the mechanical stress in plaque could help on assessing plaque vulnerability. To look into the stress conditions in the coronary artery, a patient-specific coronary model was created by using optical coherence tomography (OCT) and angiography imaging data. The reconstructed coronary model consisted of the structure of the lumen, the arterial wall and plaque components. Benefited by the high resolution of OCT, detailed structures such as the thin fibrous cap could be observed and built into the geometry. On this reconstructed coronary model, a fully coupled fluid–structure interaction (FSI) simulation was performed. The principle stress in coronary plaque and the wall shear stress (WSS) were analyzed. The FSI simulation results show that the cap thickness had a significant effect on the stress, and the principle stress at the thin cap area was more than double of those at the locations with a larger thickness. WSS is thought as an important parameter to assess the potentially dangerous areas of the atherosclerosis-prone (caused by low WSS) and the plaque rupture (high WSS). From the WSS plots of our FSI model, the area with abnormal WSS value was detected around the position where a lipid core existed. The FSI simulation results were compared with the results from the conventional structure-only and the computational fluid dynamics (CFD)-only computational models to quantify the difference between the three models. We found little difference in the principle stress results between the FSI and the structure-only model, but a significant difference between the FSI and the CFD-only model when looking into the WSS. The WSS values at the two observation spots from the CFD-only model were higher than the values from the FSI model by 17.95% and 22.66% in average, respectively. Furthermore, the FSI model detected more areas of low WSS, because the fluid domain could expand circumferentially when pressure loaded on the flexible arterial. This study suggests that OCT-based FSI model may be useful for plaque vulnerability assessment and it may be critical to perform the FSI simulation if an accurate WSS value is required.