Enhanced External Counterpulsation Treatment May Intervene The Advanced Atherosclerotic Plaque Progression by Inducing The Variations of Mechanical Factors: A 3D FSI Study Based on in vivo Animal Experiment

Growing evidences suggest that long-term enhanced external counterpulsation (EECP) treatment can inhibit the initiation of atherosclerotic lesion by improving the hemodynamic environment in aortas. However, whether this kind procedure will intervene the progression of advanced atherosclerotic plaque remains elusive and causes great concern in its clinical application presently. In the current paper, a pilot study combining animal experiment and numerical simulation was conducted to investigate the acute mechanical stress variations during EECP intervention, and then to assess the possible chronic effects.An experimentally induced hypercholesterolemic porcine model was developed and the basic hemodynamic measurement was performed in vivo before and during EECP treatment. Meanwhile, A 3D fluid-structure interaction (FSI) model of blood vessel with symmetric local stenosis was developed for the numerical calculation of some important mechanical factors. The results show that EECP augmented 12.21% of the plaque wall stress (PWS), 57.72% of the time average wall shear stress (AWSS) and 43.67% of the non-dimensional wall shear stress gradient (WSSGnd) at throat site of the stenosis. We suggest that long-term EECP treatment may intervene the advanced plaque progression by inducing the significant variations of some important mechanical factors, but its proper effects will need a further research combined follow-up observation in clinic.