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Mulvihill JJ, Cunnane EM, McHugh S, Kavanagh EG, Walsh SR, Walsh MT
Mechanical, biological and structural characterisation of in vitro ruptured human carotid plaque tissue.
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Recent experimental studies performed on human carotid plaques have focused on mechanical characterisation for the purpose of developing material models for finite element analysis without quantifying the tissue composition or relating mechanical behaviour to pre-operative classification. This study characterises the mechanical and biological properties of 25 human carotid plaques as well as investigates the common features that lead to plaque rupture during mechanical testing by performing circumferential uniaxial tests, Fourier Transform Infra-Red (FTIR) and scanning electron microscopy (SEM) on each specimen to relate plaque composition to mechanical behaviour. Mechanical results revealed large variations between plaque specimen behaviour with no correlation to pre-operative ultrasound prediction. However, FTIR classification demonstrated a statistically significant relationship between stress and stretch values at rupture and the level of calcification (p = 0.002 and p = 0.009). Energy dispersive X-ray spectroscopy was carried out to confirm that the calcium levels observed using FTIR analysis were accurate. This work demonstrates the potential of FTIR as an alternative method to ultrasound of predicting plaque mechanical behaviour. SEM imaging at the rupture sites of each specimen highlighted voids created by the nodes of calcifications in the tissue structure which could lead to increased vulnerability of the plaque.
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