Impact of local vessel curvature on the circumferential plaque distribution in coronary arteries

摘要

Plaque in native coronary arteries is hypothesized to accumulate more likely along the inner curvature of a vessel segment as compared to its outer curvature. This behavior is likely associated with differences in local shear stress, which tends to be lower on the inner bend of a curved vessel than on the outer bend. The reported in-vivo study evaluated how the circumferential plaque distribution depends on local vessel curvature in coronaries from a limited set of 12 patients. Geometrically correct models of the vessel segments were generated utilizing fusion between biplane angiography and intravascular ultrasound. The plaque thickness was derived from the 3-D borders of the lumen/plaque and media/adventitia interfaces. Within each frame, plaque thickness was classified into "below-average" and "above-average" regions. A local curvature index was defined for each point: A positive value indicates the "inner" curvature, a negative value the "outer" curvature, with the magnitude determined from differential geometry. In the majority of the examined vessels, regions of "below-average/outer-curvature" and "above-average/inner-curvature" combined outweighed the "below-average/inner-curvature" and "above-average/outer-curvature" regions. The ratio increased with the threshold to exclude lower-curvature regions, confirming the hypothesis that plaque is more likely to accumulate on the luminal surface along the inner curvature of the coronary segment.