The rupture of a vulnerable plaque, known as ulceration, is the most common cause of myocardial infarction. It can be recognized by angiographic features, such as prolonged intraluminal filling and delayed clearance of the contrast liquid. The diagnosis of such an event is an open challenge due to the limited angiographic resolution and acquisition frequency. The treatment of ulcerated plaques is an open discussion, due to the high heterogeneity and the lack of evidences that support particular strategies. Therefore, the therapeutic decision should follow a detailed investigation with angiography and intravascular imaging, such as optical coherence tomography (OCT), to locate the lesion, besides its geometric features and the lumen occlusion severity. The aim of this study is the application of a framework for the in-silico analysis of the disrupted hemodynamics due to an ulcerated lesion. The study employed a validated OCT-based reconstruction methodology and computational fluid dynamics (CFD) simulations for the computation of local hemodynamic quantities, such as wall shear stress. The reported findings, such as disrupted pre-operative flow conditions, proved the applicability of the developed framework for CFD analyses on complicated patient-specific anatomies that feature ulcerated plaques. The prediction of lesion expansion and the clinical decision making can benefit from a reliable computation of wall shear stress distributions that result from the peculiar anatomy of the lesion. The application of intravascular OCT imaging, high fidelity 3D reconstructions and CFD simulations might guide the treatment of such pathology.

中文翻译：

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基于OCT的3D重建框架在溃疡性冠状动脉斑块血流动力学评估中的应用。

易碎斑块的破裂（称为溃疡）是心肌梗塞的最常见原因。它可以被血管造影特征所识别，例如长时间的腔内填充和延迟的造影剂清除。由于有限的血管造影分辨率和采集频率，这种事件的诊断是一个开放的挑战。由于高度异质性和缺乏支持特定策略的证据，溃疡斑的治疗是一个公开讨论。因此，治疗决策应遵循血管造影和血管内成像（如光学相干断层扫描（OCT））的详细调查，以定位病变，除了其几何特征和管腔闭塞严重程度。这项研究的目的是为因溃疡病灶而引起的血流动力学破坏的计算机内分析提供一种框架。该研究采用了经过验证的基于OCT的重建方法和计算流体力学（CFD）模拟来计算局部血液动力学量，例如壁剪应力。报道的发现，如术前血流状况中断，证明了所开发框架的CFD分析适用于以溃疡斑为特征的复杂患者特定解剖结构。病变扩展的预测和临床决策可得益于对病变特殊解剖结构产生的壁切应力分布的可靠计算。血管内OCT成像的应用