Low pressure condition of a lipid core in an eccentrically developed carotid atheromatous plaque: a static finite element analysis

Plaque ruptures in atherosclerotic carotid arteries cause cerebral strokes. Accumulation of lipoproteins in the deep intimal layer forms a lipid core (LC), whose progression may be enhanced by mechanical conditions on the arterial wall. In this study, we investigated the pressure conditions of a liquid LC through numerical simulations of a sliced segment finite element (FE) model and a three-dimensional (3D) symmetric FE model. A model of an LC filled with nearly incompressible fluid was compared with incompressible and soft neo-Hookean LC models in a static FE analysis. Material constants for a nonlinear hyperelastic model of the arterial wall were identified based on an inflation test using a tube specimen. The results from the FE analysis of a sliced segment model show an LC fluid pressure as low as 1.9 kPa at a blood pressure of 16 kPa. A neo-Hookean LC model with a Young’s modulus of 0.06 kPa produced an almost uniform pressure in the LC within an error of 1.3 %. The 3D model predicted a similar level of LC pressure. Such low fluid pressure in the LC region may enhance the infiltration of lipoproteins and other substances from the lumen and facilitate transport through microvessels from the adventitia to the LC.