Modelling plaques to reduce incidence of heart attacks and strokes


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Atherosclerosis is the number one killer of people in the developed world.  Atherosclerotic plaques begin to form in adults from a young age and gradually worsen over time.  By the age of 65, it is thought that the majority of people will have some form of atherosclerosis.  It can cause a number of catastrophic events to occur such as heart attacks and strokes.  The growth of plaques can cause arteries to narrow, known as stenosis, which can be readily identified using medical imaging methods.  However, in the majority of cardiovascular events caused by atherosclerosis, it is as a result of an atherosclerotic plaque suddenly rupturing and causing blood clots to form and block the artery.  It is therefore essential to assess the vulnerability of a patient specific plaque so preventative measures and/or treatment can be implemented as soon as possible.  This project is the first step in the process to produce a vulnerability assessment method of plaques specific to a patient

Background

An atherosclerotic plaque is the build up of fatty material in an artery lining.  As these plaques grow, they restrict blood flow in the artery and in the case of a ruptured plaque, cause a blood clot to form and completely block the artery.  These restrictions and blockages can have severe ramifications, resulting in serious medical events to occur such as heart attacks and strokes. Atherosclerosis cannot be reversed using current medical procedures but its growth can be slowed and it’s effects subdued.  It is therefore crucial to identify the formation of such plaques as early as possible while also assessing the likelihood of plaque rupture in more developed plaques.

Within each atherosclerotic plaque, there are a number of constituent components.  These components have differing mechanical properties, and previous studies have shown that the arrangement and size of the components has a significant effect on the risk of plaque rupture.  In particular, it is known that there are three arrangements of plaque that have a very high rupture risk.

How is this project building on current knowledge

We have developed a modelling method that is able to simulate materials of different properties and how they interact with a fluid flow.  Using this method, we can model each of the components of an atherosclerotic plaque individually, looking at the effects of size, location and arrangements of these components and how they are affected by fluid flow.  This will give a clearer indication of the risk of rupture for a given plaque.  Initial work in Phase 1 of this project will use an idealized geometry of each of the three atherosclerotic plaques known to have a high risk of rupture and perform a parameter study upon them.  This will involve varying the size of each component to represent growth of the plaque, in order to understand the mechanical effects of blood flow on the plaque during growth.  Phase 2 will involve the inclusion of patient-specific plaque geometries, acquired through medical imaging, in the method in order to assess the risk of plaque rupture for a given patient.  This will allow clinicians to make a more informed decision about the necessity of any preventative measures that are required to slow the atherosclerotic plaque growth and reduce the risk of any catastrophic events occurring due to a plaque rupture.

Why you believe this project relevant

A number of previous studies have identified physiological and mechanical risk factors associated with the rupture of atherosclerotic plaques.  Simulations of patient-specific plaques have also been conducted, with some modelling individual components of the plaque. However, the structural model included within our method allows for defects to modelled and their effects to be investigated.  In addition, the type of method we use is particularly well suited to the use of graphics cards (in a similar way to computer games) that will allow simulations to be completed in much shorter times.  This also opens up the opportunity to perform the simulations bedside and enable clinicians to obtain a rupture risk assessment much faster than using traditional computing methods.

Project Goal

The overall aim of this project is to provide clinicians with an accurate but fast assessment of the risk of rupture for a specific patient’s atherosclerotic plaque.  In the short term, the goal is implement the method on a graphics card and perform a parameter study of idealised plaques in order to greater understand the contributions of each component of the plaque to its overall characteristics when interacting with blood flow.  

Budget

Overall fundraising total = £1200

The funds raised through this campaign will allow procurement of a computer containing a high performance graphics card that will be used to run the simulations (£1000).  This computer is also portable and will be used in various outreach activities that will be associated with the project (£200 towards materials/transport for outreach activities).   Any additional funds raised will be attributed to scans of patients in order to obtain patient-specific plaques geometries.

Team

I am an engineering PhD student at the University of Manchester developing methods to model the interaction between fluids and structures in cardiovascular applications.  Under the supervision of Dr. Alistair Revell, the research group has a strong background in numerical modelling of fluids and fluid-structure interaction for various applications.  Working in collaboration with clinicians from the Manchester University NHS Foundation Trust, these methods are currently being applied to a number of different cardiovascular applications.

Endorsement

“This novel simulation platform has the potential to radically modify the use-mode of patient specific simulation in the healthcare industry. At present most bioengineering efforts look to repurpose simulation tools developed for classical engineering sectors towards clinical use- whereas this would be developed with clinical needs in mind from the bottom up. Furthermore, the relative affordability, portability and scalability of GPU computing would mean that this technology could be both mobile and used in remote environments.” Dr Alistair Revell

Publications

Computational hemodynamics of abdominal aortic aneurysms: Three-dimensional ultrasound versus computed tomography._B. Owen, C. Lowe, N. Ashton, P. Mandal, S. Rogers, W. Wein, C. McCollum, A. Revell._Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. DOI: https://doi.org/10.1177/0954411915626742

Structural Modelling of the Cardiovascular System

B.Owen, N. Bojdo, A. Jivkov, B. Keavney, A. Revell Biomechanics and Modeling in Mechanobiology (Under review)

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Select your pledge amount

£

CONTINUE
  • 9 Backers

    Thank you for contributing to our work. We will send all supporters updates on the research.

  • 11 Backers

    Thank you for contributing to our work.

  • 5 Backers

    Thank you for contributing to our work.

  • 3 Backers

    Thank you for contributing to our work.

  • Backers

    Thank you for contributing to our work.

  • Backers

    Thank you for contributing to our work.

  • Backers

    A pledge at this level will pay for the kit we need in one go! If this leads to us overfunding, it will mean we can attribute it to scans of patients in order to obtain patient-specific plaques geometries.