In vivo based biomechanics of right and left coronary arteries

Abstract

A realistic/comprehensive biomechanical model of right/left coronary arteries is developed using the in vivo geometric and haemodynamic properties obtained from optical coherence tomography (OCT), angiography, and electrocardiography (ECG). The developed biomechanical model is constructed with the help of an image processing technique and simulated via the finite element method (FEM) for determination of regions with highest shear/von Mises stresses (which determine the potential areas for plaque rupture and initiation of myocardial infarction). A set of simulation results is compared to clinically obtained data to assess the validity of modelling/simulations. The model comprehensively incorporates information relating to three dimensionality, realistic geometry, hyper/viscoelasticity, blood viscosity, heart motion, blood pulsation, and artery bed (i.e. surrounding heart tissue). In vivo clinical data from two patients who underwent coronary angiography for clinical indications is used for modelling/simulations, one of whom had a mild (20%) stenosis in the left circumflex artery and the other had a right coronary artery (RCA) which was initially 100% occluded in its mid segment (following aspiration thrombectomy to remove clot, the RCA was left with diffuse mild (30–40%) narrowing) and then OCT was used to examine this further and showed proximal thin-capped lipid-rich plaque.