The role of hemodynamics in the formation of atherosclerotic plaques

Carotid artery plaques pose a significant threat to human life and health, with the hemodynamics playing a crucial role in their formation and progression. In this study, we reconstructed geometric models of pre-pathological carotid arteries from the computed tomography angiography images. Using computational methods of fluid–structure interaction, key hemodynamic parameters that influence the plaques formation are investigated in the carotid arteries, such as time-averaged wall shear stress and oscillatory shear index (OSI). Additionally, a correlation between the shape index of endothelial cells and the hemodynamic parameters is established. Then, combining the pathology of atherosclerosis, a set of mathematical models is constructed to describe the transendothelial transport and evolution of key substances involved in plaque formation within the carotid arterial wall, thereby predicting high-risk areas for plaque formation. The results indicate a higher risk area around the carotid bifurcation, consistent with recirculation zones of blood flow and characterized by low WSS and high OSI. The risk areas predicted by our mathematical models are well validated by clinical images, suggesting the accuracy of models established in the study. This method predicts high-risk areas of plaque formation and provides valuable guidance for the clinical diagnosis and treatment.