Histology-Based, Lesion-Specific Modeling of Stress Differences Between Plaque Rupture and Plaque Erosion

Plaque erosion is a cause of thrombosis wherein a thrombus forms over an atherosclerotic plaque without any disruption of the fibrous cap. This is in contrast to plaque rupture, traditionally considered the main cause of atherosclerosis-related thrombosis and frequently studied in biomechanics, wherein the fibrous cap becomes disrupted and exposes the lipid core of the plaque to the blood pool. Also unlike plaque rupture, plaque erosion has been observed to happen most frequently in women [1]. Despite identification, the cause of plaque erosion remains unknown and has been virtually unstudied from a biomechanical perspective. In this study, we employ a unique high-resolution, histology-based finite element model of solid wall stresses to investigate biomechanical differences between plaque rupture and plaque erosion. In future studies, this computed stress distribution can be correlated to expression of biomarkers related to the plaque disruption process in order to investigate the cause of plaque erosion.