Evolution and rupture of vulnerable plaques: a review of mechanical effects

Abstract

See, stats, and : https : / / www . researchgate. net / publication / 258022271 Evolution : a review Article DOI : 10 . 2147 / CPT . S32050 CITATIONS 4 READS 88 2 : Some : Mechanobiology Pauline Institut 19 SEE Kerry Monash (Australia) 284 , 970 SEE All . The . All - text and , letting . Abstract : Atherosclerosis occurs as a result of the buildup and infiltration of lipid streaks in artery walls , leading to plaques . Understanding the development of atherosclerosis and plaque vulnerability is of critical importance , since plaque rupture can result in heart attack or stroke . Plaques can be divided into two distinct types : those that rupture (vulnerable) and those that are less likely to rupture (stable) . In the last few decades , researchers have been interested in studying the influence of the mechanical effects (blood shear stress , pressure forces , and structural stress) on the plaque formation and rupture processes . In the literature , physiological experimental studies are limited by the complexity of in vivo experiments to study such effects , whereas the numerical approach often uses simplified models compared with realistic conditions , so that no general agreement of the mechanisms responsible for plaque formation has yet been reached . In addition , in a large number of cases , the presence of plaques in arteries is asymptomatic . The prediction of plaque rupture remains a complex question to elucidate , not only because of the interaction of numerous phenomena involved in this process (biological , chemical , and mechanical) but also because of the large time scale on which plaques develop . The purpose of the present article is to review the current mechanical models used to describe the blood flow in arteries in the presence of plaques , as well as reviewing the literature treating the influence of mechanical effects on plaque formation , development , and rupture . Finally , some directions of research , including those being undertaken by the authors , are described .