Risk Assessment of Carotid Atherosclerotic Plaque Rupture under Cervical Rotatory Manipulation Based on Fluid-Structure Interaction Finite Element Model
10.16156/j.1004-7220.2022.04.17
- VernacularTitle:基于流固耦合有限元模型评估颈椎旋转手法下颈动脉粥样硬化斑块的破裂风险
- Author:
Baofeng WU
1
;
Ziyu FENG
2
;
Shuyang LEI
3
;
Qiming LIAO
4
;
Yili CHEN
5
Author Information
1. Guangzhou University of Chinese Medicine
2. School of Traditional Chinese Medicine, Southern Medical University
3. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences
4. Guangzhou Youdao Computer Technology Co. Ltd,
5. No. 1 Department of Traumatology, Wang Jing Hospital of China Academy of Chinese Medical Sciences
- Publication Type:Journal Article
- Keywords:
carotid atherosclerosis;
plaque;
cervical rotatory manipulation;
rupture risk;
fluid-structure interaction(FSI)
- From:
Journal of Medical Biomechanics
2022;37(4):E684-E691
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the rupture risk of carotid atherosclerotic plaque under cervical rotatory manipulation. Methods The fluid-structure interaction (FSI) model of carotid atherosclerotic plaque was established, and tensile deformation of the plaque and lumen under cervical rotatory manipulation was simulated.Mechanical parameters such as the maximum flow shear stress(FSS), the maximum wall shear stress (WSS), the maximum plaque wall stress (PWS), wall tensile stress (WTS) and wall pressure (WP) of the plaque and lumen were recorded. Results Under 16% carotid tensile deformation, the maximum WSS of the plaque was 40.54 Pa. The maximum PWS was 66.16 kPa, which was far smaller than the threshold of plaque rupture.The maximum WTS of fiber cap and the maximum strain were 156.75 kPa and 0.56, which were larger than the fracture strain range. The maximum WTS of the lumen was 1 040.30 kPa, which approached the threshold of medial membrane rupture and might cause vascular injury. Conclusions When the cervical spine rotates to the end range of motion, large carotid artery stretch may cause damage to epidermal tissues of the plaque, leading to abscission. Lesions, ulcers, bleeding and vascular damage may form inside the plaque, which will affect stability of the plaque. Cervical rotatory manipulation should be performed cautiously in patients with cervical diseases who also have carotid atherosclerotic plaques.The finite element assessment of plaques before manipulation may be an effective safety screening method.
