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Guendouz, Y.

Publications and source records attributed to Guendouz, Y..

2 recordsLinked to original sources

Low ultimate tensile strain in atherosclerotic plaques is linked to the presence of neovascularisation: insights from ex vivo uniaxial tensile testing

BackgroundNeovascularisation, the formation of new vessels within atherosclerotic plaques, has been associated with plaque progression and intraplaque haemorrhage. However, the relationship between neovascularisation and mechanical failure of plaques remains unclear. A better understanding of this link could improve rupture risk prediction beyond traditional reliance on arterial stenosis. MethodsHuman carotid plaques (n=7) from endarterectomy were sectioned into circumferential strips (n=25) and tested under uniaxial tension with digital image correlation (DIC) to determine ultimate tensile (UT) stress, UT strain, and elastic moduli. Immunohistochemistry with CD31 staining quantified neovascularisation. K-means clustering based on UT stress and strain identified mechanical phenotypes. A decision tree classifier was trained using neovascularisation percentage as the predictor. ResultsNeovascularisation showed a moderate negative correlation with UT strain (r = -0.46, p = 0.028), indicating plaques with greater neovascularisation failed at lower strains. K-means clustering identified two groups: Cluster 1 (lower UT strain) had significantly higher neovascularisation (median 2.21%) and greater initial stiffness than Cluster 2 (median 1.27%, p < 0.01). The decision tree using neovascularisation alone achieved 78.3% classification accuracy, with an area under the curve of 0.78. DIC analysis revealed rupture consistently occurred at regions of elevated local strain. ConclusionThis study demonstrates a link between neovascularisation and mechanical failure in atherosclerotic plaques. Higher neovascularisation was associated with lower UT strain, suggesting it contributes to mechanical instability. These findings support the role of neovascularisation as a marker of plaque vulnerability and encourage its integration into ultrasound-based risk assessment strategies, such as contrast-enhanced ultrasound.

bioengineering↗

Inverse Finite Element Framework Combining Ultrasound Imaging and Inflation Testing of PVA Artery Phantoms

The clinical decision to establish if a patient with carotid disease should undergo surgical intervention is primarily based on the percent stenosis. Whilst this applies for high-grade stenosed vessels (>70%), it falls short for other cases. Due to the heterogeneity of plaque tissue, probing the mechanics of the tissue would likely provide further insights into why some plaques are more prone to rupture. Mechanical characterisation of such tissue is nontrivial, however, due to the difficulties in collecting fresh, intact plaque tissue and using physiologically relevant mechanical testing of such material. The use of polyvinyl alcohol (PVA) is thus highly convenient because of its acoustic properties and tuneable mechanical properties. MethodsThe aim of this study is to demonstrate the potential of polyvinyl alcohol phantoms to simulate atherosclerotic features. In addition, a testing and simulation framework is developed for full PVA vessel material characterization using ring tensile testing and inflation testing combined with non-invasive ultrasound imaging and computational modelling. ResultsStrain stiffening behaviour was observed in PVA through ring tensile tests, particularly at high freeze-thaw cycles. Inflation testing of bi-layered phantoms featuring lipid pool inclusions demonstrated high strains at shoulder regions. The application of an inverse finite element framework successfully recovered boundaries and determined the shear moduli for the PVA wall to lie within the range 27 kPa to 53 kPa. ConclusionThe imaging-modelling framework presented facilitates the use and characterisation of arterial mimicking phantoms to further explore plaque rupture. It also shows translational potential for non-invasive mechanical characterisation of atherosclerotic plaques to improve the identification of clinically relevant metrics of plaque vulnerability.

bioengineering↗