Imaging-Based Patient-Specific Biomechanical Evaluation of Atherosclerosis and Aneurysm: A Comparison Between Structural-Only, Fluid-Only and Fluid-Structure Interaction Analysis

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. Atherosclerosis is the dominating underlying cause of CVD, that occurs at susceptible locations such as coronary and carotid arteries. The progression of atherosclerosis is a gradual process and most of the time asymptomatic until a catastrophic event occurs. Similarly, an intracranial aneurysm is the bulging of the cerebral artery due to a weakened area of the vessel wall. The progression of the aneurysm could result in the rupture of the vessel wall leading to a subarachnoid haemorrhage. The formation and progression of atherosclerosis and aneurysm are closely linked to abnormal blood flow behaviour and mechanical forces acting on the vessel wall. Recent technologies in medical imaging, modeling, and computation are used to estimate critical parameters from patient-specific data. However, there is still a need to develop protocols that are reproducible and efficient. This article focuses on the methods for biomechanical analysis of the cerebral aneurysms and atherosclerotic arteries including carotid & coronary. In this study, patient-specific 3D models were reconstructed from optical coherence imaging (OCT) for coronary and magnetic resonance imaging (MRI) for the carotid and cerebral arteries. The reconstructed models were used for computational fluid dynamics (CFD), structural-only, and fluid-structure interaction (FSI) simulations. The results of the FSI were compared against structural and CFD-only simulations to identify the most suitable method for each artery. The comparison between FSI and structural only simulations for the coronary artery showed similar mechanical stress values across the cardiac cycle with a maximum difference of 1.8%. However, the results for the carotid and cerebral arteries showed a maximum difference of 5% and 20% respectively. Additionally, with relation to the hemodynamic WSS calculated from FSI and CFD-only, the coronary artery presented a significant difference of 87%. Conversely, the results for the carotid and cerebral arteries showed a maximum difference of 9 and 6.4% at systole. Based on the results it can be concluded that the shape & location of the artery will influence the selection of the model that can be used for solving the numerical problem.