Quantitative analysis of circumferential plaque distribution in human coronary arteries in relation to local vessel curvature

A common hypothesis is that plaque accumulation in curved vessels is biased towards the inner bend of the curvature rather than the outer bend of the curvature. This bias in circumferential plaque distribution is likely associated with lower wall shear stress on the inner bend of the curved vessel. We quantitatively analyzed this effect in a set of 37 in-vivo human coronary artery segments from 31 patients. Three-dimensional models of the arteries were generated by an established system for fusion of image data from X-ray angiography and intravascular ultrasound. Our results showed that the hypothesis held in the majority of vessels (p < 0.001), and that the effect increases with curvature. However, no evidence could be found for a direct relationship between plaque distribution and curvature in complex vessel geometries, thus motivating a more detailed analysis of wall shear stress patterns and their impact on circumferential plaque distribution.