Abstract

Objectives The outcome of balloon-based atherosclerosis thermoplasty is closely related to the temperature/stress distribution during the treatment. For precise prediction of a required thermal lesion in the heterogeneous and thin atherosclerotic vessel, a numerical model incorporating heat-induced tissue expansion or shrinkage and the strain caused by balloon dilation is necessary. Methods A fully coupled thermal-electrical-structural new model was established. The model features a heterogeneous structure including eccentric plaque, healthy artery and surrounding tissue. Tissue expansion/shrinkage and hyperelasticity material model were taken into consideration. Different heating strategies and plaque mechanical properties were investigated. The temperature distribution was compared with the traditional thermal-electrical coupled model. The possibility of thermoplasty treatment using balloons with different sizes was also explored. Results The temperature, the electrical intensity and the stress during the thermoplasty were obtained. Lower stress was found in the heating region where tissue shrinkage occurred. The ablation depth was predicted to be ∼0.42 mm larger without coupling the biomechanical influence. The mechanical properties and input condition significantly affect the temperature and stress distribution considering the small dimensions of the tissue. Besides, with a 12.5% reduction of balloon diameter, the largest Von Mises stress decreases by 25.4%. Conclusions It is confirmed that a coupled thermal-electrical-structural model is needed for precise temperature prediction in the balloon-based thermoplasty of the heterogeneous and thin tissue. The model presented may help with future development of optimized treatment planning considering both ablation depth and minimum stress.

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