Chapter 5 - Simulation of carotid artery plaque development and treatment

Abstract

One of the diseases of the human cardiovascular system is carotid artery stenosis. This disease is characterized by the constriction of the arterial wall, caused by the atherosclerotic plaque that further causes anomalies in the blood flow. One of the noninvasive imaging techniques that are applied in clinical examination is the ultrasound. Using ultrasound, two-dimensional cross-sectional images are obtained that are afterwards analyzed by the clinical staff. Computer tools could be useful in providing more information during this examination. In this chapter several computational methods are combined to create a tool that enables extraction of relevant information from clinical images and more detailed analysis of state of patient's carotid artery. The presented approach uses deep learning computational techniques to automatically extract the shape of the carotid artery and determine atherosclerotic plaque constituents from imaging data. The segmented data is used to perform a three-dimensional reconstruction of the patient-specific geometry. The reconstructed geometry is used to simulate plaque progression and also to simulate stent implantation and subsequently blood flow simulation, to determine the restoration of blood flow after stenting intervention. The capabilities of the presented complex numerical model are illustrated through the results of simulations for a specific patient. With the presented approach clinicians can analyze the state of the patient's carotid artery in more detail, perceive regions of further plaque development and plan possible stent implantation treatment. Also, they can analyze the outcome of the stenting intervention and again investigate the relevant blood flow and plaque progression parameters prior to the intervention. This whole approach can help to achieve a more detailed and patient-specific diagnostics and treatment planning.