Biomechanics of plaque rupture: Progress, problems, and new frontiers
Biomechanics of plaque rupture: Progress, problems, and new frontiers
复制标题
DOI：
10.1114/1.1482781
复制
发表时间：
2002-04-01
影响因子：
3.8
通讯作者：
Richardson, PD
中科院分区：
文献类型：
--
作者：
Richardson, PD
斑块破裂已被确定为动脉斑块演变的关键步骤，特别是当临床上重要的事件发生在关键动脉中时。在过去的十几年里，考虑哪些斑块是脆弱的，即使还没有破裂，这已经变得很普遍。血栓形成事件仍然很重要，但在这种情况下，它们被视为往往是由斑块破裂触发的。将结构力学、流体力学、菌斑形态学的考虑因素编织在一起。流行病学病理学，动脉壁组织的微机械测量，以及基质金属蛋白酶的复杂作用的新信息，这一重要的审查提请注意相对缺乏的数据（i）动脉组织的小测试部分的机械行为和（ii）斑块的位置与局部血管曲率和曲率弯曲的关系。这在心外膜动脉中尤其重要，其中双平面血管造影和血管内超声（两者在数字记录中变得越来越可用）的组合提供了与生物力学相关的临床研究的机会。这在以前是不可能的。改进的成像和局部组织特性评估为颈动脉分叉提供了相关的机会。讨论包括一个建议，制定一个评估规模斑块的脆弱性。(C)2002生物医学工程学会。
Plaque rupture has become identified as a critical step in the evolution of arterial plaques, especially as clinically significant events occur in critical arteries. It has become common in the past dozen years or so to consider which plaques are vulnerable, even though not yet ruptured. Thrombotic events have remained significant, but in a context where they are seen as being triggered often by plaque rupture. Weaving together considerations from structural mechanics, fluid mechanics, plaque morphology. epidemiological pathology, micromechanical measurements of arterial wall tissues, and emerging information on the complex roles of the matrix metalloproteinases, this critical review draws attention to the relative paucity of data (i) on the mechanical behavior of small test portions of arterial tissues and (ii) on the relation of plaque locations to local vessel curvature and curvature flexure. This is especially important in the epicardial arteries, where combination of biplane angiograms and intravascular ultrasound (both becoming increasingly available in digital recordings) offer opportunities for clinical investigation, allied to biomechanics. to an extent previously not possible. Improved imaging and local tissue property assessments provide related opportunities for the carotid bifurcation. The discussion includes a proposal for developing an assessment scale for plaque vulnerability. (C) 2002 Biomedical Engineering Society.