Flow Residence Time and Regions of Intraluminal Thrombus Deposition in Intracranial Aneurysms

Rayz, Vitaliy L.; Boussel, Loîc; Ge, Liang; Leach, Joseph; Martin, Alastair J.; Lawton, Michael T.; McCulloch, Charles E.; Saloner, David

doi:10.1007/s10439-010-0065-8

Cited by 192 publications

(175 citation statements)

References 25 publications

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“…These observations are physically similar to the separation of the boundary-layer downstream of stenoses, where Raz et al [30] showed the direct relationship between platelet recirculation time and both platelet activation and acetylated thrombin generation. Furthermore, Rayz et al [31] observed thrombus deposition in certain regions of patient-specific intracranial geometries with an increase in residence time and low WSS. More recently, Boyd et al found that AAA rupture tended to occur in thrombus afflicted regions with predicted flow recirculation and low WSS [32].…”

Section: Introductionmentioning

confidence: 99%

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

Kelsey

Powell

Norman

et al. 2016

Numer Methods Biomed Eng

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Aneurysms of the common iliac artery (CIAA) are most commonly seen in association with an abdominal aortic aneurysm (AAA). Isolated CIAAs, in the absence of an AAA, are uncommon. Similar to AAAs, CIAA may develop intraluminal thrombus (ILT). As isolated CIAAs have a contralateral common iliac artery for comparison, they provide an opportunity to study the haemodynamic mechanisms behind ILT formation.In this study, we compared a large isolated CIAA and the contralateral iliac artery using computational fluid dynamics (CFD) to determine if haemodynamic metrics correlate with the location of ILT. We performed a comprehensive CFD study and investigated the residence time of platelets and monocytes, velocity fields, time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI) and endothelial cell activation potential (ECAP). We then correlated these data to ILT burden determined with computed tomography (CT).We found that high cell residence times, low TAWSS, high OSI and high ECAP all correlate with regions of ILT development. Our results show agreement with previous hypotheses of thrombus formation in AAA and provide insights into the computational haemodynamics of iliac artery aneurysms.

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Section: Introductionmentioning

confidence: 99%

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

Kelsey

Powell

Norman

et al. 2016

Numer Methods Biomed Eng

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“…To track contrast agent, Rayz et al solved an advection equation with a zero source term. 19 Narracott et al calculated RT to model clot formation in a stenosis using an advection-diffusion equation with a non-zero source term. 20 In that study, a non-zero source term was used for the entire computational domain and dye was advected from the inlet, so the value of RT depended on the distance from the model inlet to the region of interest.…”

Section: Introductionmentioning

confidence: 99%

A non-discrete method for computation of residence time in fluid mechanics simulations

2013

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Cardiovascular simulations provide a promising means to predict risk of thrombosis in grafts, devices, and surgical anatomies in adult and pediatric patients. Although the pathways for platelet activation and clot formation are not yet fully understood, recent findings suggest that thrombosis risk is increased in regions of flow recirculation and high residence time (RT). Current approaches for calculating RT are typically based on releasing a finite number of Lagrangian particles into the flow field and calculating RT by tracking their positions. However, special care must be taken to achieve temporal and spatial convergence, often requiring repeated simulations. In this work, we introduce a non-discrete method in which RT is calculated in an Eulerian framework using the advection-diffusion equation. We first present the formulation for calculating residence time in a given region of interest using two alternate definitions. The physical significance and sensitivity of the two measures of RT are discussed and their mathematical relation is established. An extension to a point-wise value is also presented. The methods presented here are then applied in a 2D cavity and two representative clinical scenarios, involving shunt placement for single ventricle heart defects and Kawasaki disease. In the second case study, we explored the relationship between RT and wall shear stress, a parameter of particular importance in cardiovascular disease. C 2013 AIP Publishing LLC. [http://dx

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“…It is well established that the WSS or WSR may be responsible for the remodeling of the vascular endothelium, and WSR has been correlated with the location of vascular thrombus in the previous study (36). The WSR clearly indicates the strength of near-wall flow relative to the wall, since it is defined by the flow velocity gradient at the wall.…”

Section: Methodsmentioning

confidence: 68%

A coupled chemo-fluidic computational model for thrombogenesis in infarcted left ventricles

Seo

Abd

George

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

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Seo JH, Abd T, George RT, Mittal R. A coupled chemo-fluidic computational model for thrombogenesis in infarcted left ventricles. Am J Physiol Heart Circ Physiol 310: H1567-H1582, 2016. First published March 25, 2016; doi:10.1152/ajpheart.00855.2015.-A coupled chemo-fluidic computational model for investigating flowmediated thrombogenesis in infarcted left ventricles (LVs) is proposed. LV thrombus (LVT) formation after the acute myocardial infarction (AMI) may lead to thromboembolic events that are associated with high mortality and morbidity, and reliable stratification of LVT risk is the key to managing the treatment of AMI patients. There have been several studies emphasizing the importance of LV blood flow patterns on thrombus formation; however, given the complex interplay between ventricular flow dynamics and biochemistry of thrombogenesis, current understanding is mostly empirical. In the present model, blood flow in the LV is obtained by solving the incompressible Navier-Stokes equations, and this is coupled to the biochemical modeling of the coagulation cascade, platelet activation, and fibrinogen polymerization. The coupled model is used to examine the effect of ventricular flow patterns on thrombogenesis in modeled ventricles. It is expected that the method developed here will enable in-depth studies of thrombogenesis in patient-derived infarcted LV models. computational hemodynamics; cardiac flow; intraventricular flow; blood clot; coagulation cascade; biochemical reaction NEW & NOTEWORTHY A computational method that simultaneously resolves the left ventricular flow patterns as well as the biochemical coagulation cascade (CC) is proposed. The method enables a clear identification of the effect of flow patterns on left ventricular thrombogenesis and suggests a metric quantitatively correlated to thrombogenic risk.ONE OF THE MOST FEARED COMPLICATIONS for patients with acute myocardial infarction (AMI) is the occurrence of thromboembolic events associated with left ventricular (LV) thrombus (LVT) formation (11) and cardioembolic strokes, which account for 20 -30% of all ischemic strokes (25,27,33). The identification of high-risk patients and the pharmacological prevention of LVT formation are the keys to preventing these embolic events. Thrombus formation results from the combination of disturbed blood flow patterns, endothelial injury, and hypercoagulability of the endothelium. After AMI, LV regional wall akinesia or dyskinesia changes the patterns of blood flow in the LV, and this can result in local stasis of blood flow (3). Prolonged ischemia also leads to subendocardial tissue injury with inflammatory changes and may lead to the development of a LV aneurysm (30, 34), which may cause further abnormalities in LV flow. Furthermore, patients with acute coronary syndrome show a hypercoagulable state with increased concentrations of prothrombin and fibrinopeptide (11). The above prerequisites in the LV with AMI lead to the formation of LVT composed of fibrin, platelets, and red blood cells.Risk factors f...

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Flow Residence Time and Regions of Intraluminal Thrombus Deposition in Intracranial Aneurysms

Cited by 192 publications

References 25 publications

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

A non-discrete method for computation of residence time in fluid mechanics simulations

A coupled chemo-fluidic computational model for thrombogenesis in infarcted left ventricles

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