Preoperative Image-Based Simulation of Carotid Artery Stenting Considering Agatston Score of Calcified Plaques

摘要

The role of calcification inside fibroatheroma during carotid artery stenting operation is controversial. Cardiologists face a major problem in placing stents: "plaque protrusion" i.e. elastic fibrous caps containing early calcifications that penetrate inside the stent. The aim of this work is to assess the contribution of calcification to plaque vulnerability by using image-based models of carotid artery stenting. Technically, Finite Element Analysis was used to simulate the balloon and stent expansion as a preoperative virtual framework. A nonlinear static structural analysis was performed on 20 image-based models of patients reconstructed from Multidetector Computer Tomography (CT) angiography acquisitions. Subject-specific local Elastic Modulus (EM) of calcified plaques was estimated using the Agatston Calcium (Ca) score, as obtained from CT images.