The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

The effect of multidirectional wall shear stress on plaque characteristics: delving deeper into local shear stress metrics

EuroIntervention 2019;15:656-658. DOI: 10.4244/EIJV15I8A121

1. Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 2. Mechanical and Industrial Engineering Department, Northeastern University, Boston, MA, USA


The goal of investigations to risk-stratify individual coronary plaques over the past few decades has been to identify the so-called “vulnerable plaque”, i.e., a high-risk plaque on a trajectory towards plaque destabilisation and precipitation of a new clinical event, so that pre-emptive interventions could be utilised to interrupt that trajectory and avert the adverse event. Initial efforts focused on anatomic characterisation of the plaque, but prognostication based on plaque anatomy features has consistently been inadequate to influence clinical decision making1,2,3,4. Most plaques, including ostensibly high-risk plaques based on plaque anatomy characteristics alone, remain quiescent and do ...

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