Carotid atherosclerosis is a common cause of acute ischemic stroke and places a major burden on worldwide health-related quality of life. The currently-used stenosis-degree guidelines to decide on surgical intervention through carotid endarterectomy in order to prevent a future event are imperfect. This is because they insufficiently target plaque vulnerability. To provide an alternative carotid plaque vulnerability assessment, one can compute the biomechanical peak cap stress using noninvasive magnetic resonance imaging (MRI). In this dissertation, we used MRI simulations to assess the accuracy of plaque segmentation and stress analysis. We also investigated plaque elasticity estimation through combining inverse finite element analysis and ultrasound strain measurements. A comparison between peak cap stress and histological classification led to the finding that a reliable identification of thick-cap stable carotid plaques might be a more fruitful approach to reduce carotid surgeries on stenosis-inducing, yet stable plaques.

Additional Metadata
Keywords Atherosclerosis, plaque, magnetic resonance imaging, modeling, fibrous cap, carotid, finite element analysis
Promotor A.F.W. van der Steen (Ton)
Publisher Erasmus University Rotterdam
Sponsor Financial support by the Dutch Heart Foundation for the publication of this thesis is gratefully acknowledged. Additional financial support for the printing of this thesis was kindly provided by Cardialysis and Philips Healthcare. This research was performed within the framework of CTMM, the Center for Translational Molecular Medicine, project PARISk (grant 01C-202), and supported by a grant of the Dutch Heart Foundation (DHF-2008T094).
ISBN 978-94-6299-043-2
Persistent URL hdl.handle.net/1765/77999
Nieuwstadt, H.A. (2015, April 22). MRI-based Biomechanical Modeling of Carotid Atherosclerotic Plaques. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/77999