Association of endothelial shear stress with plaque thickness in a real three-dimensional left main coronary artery bifurcation model

We report for the first time a real three-dimensional reconstruction of the left main coronary artery, left main bifurcation, left anterior descending coronary artery and left circumflex coronary artery using biplane angiography and intravascular ultrasound imaging in a patient with a proximal stenosis in the left anterior descending coronary artery. By using computational fluid dynamics in the three-dimensional luminal model we computed endothelial shear stress, while plaque thickness was calculated as the difference between the three-dimensional lumen and outer vessel wall; plaque thickness was found to be inversely related to endothelial shear stress in the left main coronary artery and bifurcation. The application of our methodology for real three-dimensional reconstruction of the left main coronary artery and bifurcation is useful for investigating the relationship of hemodynamic parameters with plaque thickness in this critical coronary region.