Fundamentals of coronary biomechanics
Summary
Biomechanical stress plays an important role in vascular disease and this chapter summarises the basic principles of the vascular biomechanical stress state.
One component of this stress state is blood flow induced shear stress. This stress results from frictional forces between blood and the wall. Shear stress is small in magnitude and is mainly sensed by the endothelium. In human coronaries, shear stress can be quantified by combining 3D imaging with computational techniques. These techniques allow us to study the relationship between shear stress, plaque localisation and progression as well as in-stent restenosis.
Other components of the vascular mechanical stress state include wall stresses. These stresses are much larger and are directly related to the deformation of the vessel wall, induced by blood pressure, angioplasty balloons or stents. Constitutive laws are used to describe the relationship between deformation and stress states. Combined with patient-specific images, we can predict the stress state using finite element analysis. Knowing stresses in the wall, we can study blood pressure induced rupture risk as well as the interaction between devices and the diseased vessel wall.
Introduction
Blood flow transmits forces to the arterial wall which, when normalised by area, are called stresses. The stresses...
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