Shear-driven modelling of thrombus formation in type B aortic dissection

Jafarinia, Alireza; Armour, Chlöe Harriet; Gibbs, Richard; Xu, Xiao Yun; Hochrainer, Thomas

doi:10.3389/fbioe.2022.1033450

Cited by 9 publications

(12 citation statements)

References 40 publications

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“…( 2022 ), as well as in a recent study by Jafarinia et al. ( 2022 ) it was found that it is possible to predict the FL thrombosis using a rigid wall assumption for patient-specific cases. To validate the results, clinical research is needed to understand the role of morphology in predicting FL thrombosis.…”

Section: Limitationsmentioning

confidence: 84%

“…Chong et al (2022) concluded that accounting for the interaction of blood flow with the flap and the wall increases the amount of thrombus in the FL by 25 %. However, in previous studies of , Menichini et al (2018), Armour et al (2020), andArmour et al (2022), as well as in a recent study by Jafarinia et al (2022) it was found that it is possible to predict the FL thrombosis using a rigid wall assumption for patient-specific cases. To validate the results, clinical research is needed to understand the role of morphology in predicting FL thrombosis.…”

Section: Limitationsmentioning

confidence: 94%

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Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Jafarinia

Melito

Müller

et al. 2023

Biomech Model Mechanobiol

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Type B aortic dissection (TBAD) carries a high risk of complications, particularly with a partially thrombosed or patent false lumen (FL). Therefore, uncovering the risk factors leading to FL thrombosis is crucial to identify high-risk patients. Although studies have shown that morphological parameters of the dissected aorta are related to FL thrombosis, often conflicting results have been reported. We show that recent models of thrombus evolution in combination with sensitivity analysis methods can provide valuable insights into how combinations of morphological parameters affect the prospect of FL thrombosis. Based on clinical data, an idealized geometry of a TBAD is generated and parameterized. After implementing the thrombus model in computational fluid dynamics simulations, a global sensitivity analysis for selected morphological parameters is performed. We then introduce dimensionless morphological parameters to scale the results to individual patients. The sensitivity analysis demonstrates that the most sensitive parameters influencing FL thrombosis are the FL diameter and the size and location of intimal tears. A higher risk of partial thrombosis is observed when the FL diameter is larger than the true lumen diameter. Reducing the ratio of the distal to proximal tear size increases the risk of FL patency. In summary, these parameters play a dominant role in classifying morphologies into patent, partially thrombosed, and fully thrombosed FL. In this study, we point out the predictive role of morphological parameters for FL thrombosis in TBAD and show that the results are in good agreement with available clinical studies.

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Section: Limitationsmentioning

confidence: 84%

Section: Limitationsmentioning

confidence: 94%

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Jafarinia

Melito

Müller

et al. 2023

Biomech Model Mechanobiol

Self Cite

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“… 2020 ; Jafarinia et al. 2022 ). In these studies, the effect of thrombus breakdown induced by high shear stress was neglected, which could result in overpredictions of thrombus volume.…”

Section: Discussionmentioning

confidence: 99%

“… 2022 ; Jafarinia et al. 2022 ), a lower threshold of shear strain rate (10 s -1 ) was adopted in BFS simulations to avoid overpredictions over the step, but a value of 50 s -1 was used in patient-specific thrombosis modeling for both accuracy and computational efficiency. In this study, we chose the same shear rate threshold of 50 s -1 in all simulations.…”

Section: Discussionmentioning

confidence: 99%

A numerical study of the effect of thrombus breakdown on predicted thrombus formation and growth

Wang

Armour

Gibbs

et al. 2023

Biomech Model Mechanobiol

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Thrombosis is a complex biological process which involves many biochemical reactions and is influenced by blood flow. Various computational models have been developed to simulate natural thrombosis in diseases such as aortic dissection (AD), and device-induced thrombosis in blood-contacting biomedical devices. While most hemodynamics-based models consider the role of low shear stress in the initiation and growth of thrombus, they often ignore the effect of thrombus breakdown induced by elevated shear stress. In this study, a new shear stress-induced thrombus breakdown function is proposed and implemented in our previously published thrombosis model. The performance of the refined model is assessed by quantitative comparison with experimental data on thrombus formation in a backward-facing step geometry, and qualitative comparison with in vivo data obtained from an AD patient. Our results show that incorporating thrombus breakdown improves accuracy in predicted thrombus volume and captures the same pattern of thrombus evolution as measured experimentally and in vivo. In the backward-facing step geometry, thrombus breakdown impedes growth over the step and downstream, allowing a stable thrombus to be reached more quickly. Moreover, the predicted thrombus volume, height and length are in better agreement with the experimental measurements compared to the original model which does not consider thrombus breakdown. In the patient-specific AD, the refined model outperforms the original model in predicting the extent and location of thrombosis. In conclusion, the effect of thrombus breakdown is not negligible and should be included in computational models of thrombosis.

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“…Tissue exposed to elevated TAWSS for an extended period has a higher likelihood of rupture, 85,86 whereas low TAWSS is likely to promote risk of endothelial cell degeneration and serves as a key activator in thrombus formation. [81][82][83] The TAWSS is evaluated for the seventh cardiac cycle adopting the RWA, E90, and gHGO models and compared in Figure 11. In all three models, areas of elevated TAWSS are found in the ascending aorta, in the true luminal arch region, near branching vessels, and in the iliac arteries due to their pronounced curvature.…”

Section: Shear Stress-based Indicatorsmentioning

confidence: 99%

On the role of tissue mechanics in fluid–structure interaction simulations of patient‐specific aortic dissection

Schussnig,

Rolf‐Pissarczyk,

Bäumler

et al. 2024

Numerical Meth Engineering

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Modeling an aortic dissection represents a particular challenge from a numerical perspective, especially when it comes to the interaction between solid (aortic wall) and liquid (blood flow). The complexity of patient‐specific simulations requires a variety of parameters, modeling assumptions and simplifications that currently hinder their routine use in clinical settings. We present a numerical framework that captures, among other things, the layer‐specific anisotropic properties of the aortic wall, the non‐Newtonian behavior of blood, patient‐specific geometry, and patient‐specific flow conditions. We compare hemodynamic indicators and stress measurements in simulations with increasingly complex material models for the vessel tissue ranging from rigid walls to anisotropic hyperelastic materials. We find that for the present geometry and boundary conditions, rigid wall simulations produce different results than fluid–structure interaction simulations. Considering anisotropic fiber contributions in the tissue model, stress measurements in the aortic wall differ, but shear stress‐based biomarkers are less affected. In summary, the increasing complexity of the tissue model enables capturing more details. However, an extensive parameter set is also required. Since the simulation results depend on these modeling choices, variations can lead to different recommendations in clinical applications.

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Shear-driven modelling of thrombus formation in type B aortic dissection

Cited by 9 publications

References 40 publications

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

A numerical study of the effect of thrombus breakdown on predicted thrombus formation and growth

On the role of tissue mechanics in fluid–structure interaction simulations of patient‐specific aortic dissection

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