Synergistic action of severe wall injury and shear forces on thrombus formation in arterial stenosis: Definition of a thrombotic shear rate threshold

Merino, Álvaro; Cohen, Marc; Badimón, Juan J.; Fuster, Valentı́n; Badimón, Lina

doi:10.1016/0735-1097(94)90875-3

Cited by 47 publications

(25 citation statements)

References 28 publications

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“…It increases sharply at around 70% occlusion. The in vivo study by Merino et al [72] showed that although platelets formed a mural thrombus in all the vascular injury models, which ranged from 0 to 92% stenosis, the thrombus progressed to occlusion only if the stenosis severity was greater than 60%. Our results suggest a similar phenomenon where an occlusion of more than 70% of the artery may result in dangerous medical condition for its rapid increase in the wall shear stress.…”

Section: Shear Stressmentioning

confidence: 97%

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Zhang

2008

Numerical Methods in Fluids

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SUMMARYNumerical analysis of pulsatile blood flow in healthy, stenosed, and stented carotid arteries is performed with the aim of identifying hemodynamic factors in the initiation, growth, and the potential of leading to severe occlusions of a diseased artery. The Immersed Finite Element Method is adopted for this study to conveniently incorporate various geometrical shapes of arteries without remeshing. Our computational results provide detailed quantitative analysis on the blood flow pattern, wall shear stress, particle residence time, and oscillatory shear index. The analysis of these parameters leads to a better understanding of blood clot formation and its localization in a stenosed and a stented carotid artery. A healthy artery is also studied to establish a baseline comparison. This analysis will assist in developing treatments for diseased arteries and novel stent designs to reduce restenosis.

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Section: Shear Stressmentioning

confidence: 97%

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Zhang

2008

Numerical Methods in Fluids

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“…found that shear rates above certain threshold values seem to promote thrombus formation [30,31], and that various features of turbulent flow also might influence [32]. Turbulent flow has also been suggested to have additional degenerative effects on blood, which is commented more in the appended papers.…”

Section: Thrombus Formationmentioning

confidence: 99%

Turbulent Flow in Constricted Blood Vessels : Quantification of Wall Shear Stress Using Large Eddy Simulation

Gårdhagen¹

2013

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No part of this publication may be reproduced, stored in a retrieval system, or be transmitted, in any form or by any means, electronic, mechanic, photocopying, recording, or otherwise, without prior permission of the author.Cover: Pipe flow becomming turbulent after a constriction. Streamlines, wall shear stress on the surface, and vorticity in three cross sections. AbstractThe genesis of atherosclerosis has previously been shown to be affected by the frictional load from the blood on the vessel wall, called the wall shear stress (WSS). Assessment of WSS can therefore provide important information for diagnoses, intervention planning, and follow-up. Calculation of WSS requires highresolved velocity data from the vessel, which in turn can be obtained using computational fluid dynamics (CFD). In this work large eddy simulation LES was successfully used to simulate transitional flow in idealized as well as subject specific vessel models. It was shown that a scale resolving technique is to prefer for this application, since much valuable information otherwise is lost. Besides, Reynolds-Averaged Navier-Stokes (RANS) models have generally failed to predict this type of flow.Non-pulsating flows of Reynolds numbers up to 2 000 in a circular constricted pipe showed that turbulence is likely to occur in the post-stenotic region, which resulted in a complex WSS pattern characterized by large spatial as well temporal fluctuations in all directions along the wall. Time averaged streamwise WSS was relatively high, while time averaged circumferential WSS was low, meaning that endothelial cells in that region would be exposed to oscillations in a stretched state in the streamwise direction and in a relaxed state in the circumferential direction.Since every vessel is unique, so is also its WSS pattern. Hence the CFD simulations must be done in subject specific vessel models. Such can be created from anatomical information acquired with magnetic resonance imaging (MRI). MRI can also be used to obtain velocity boundary conditions for the simulation. This technique was used to investigate pulsating flow in a subject specific normal human aorta. It was shown that even the flow in healthy vessels can be very disturbed and turbulence like, and even for this case large WSS variations were seen. It was also shown that regions around branches from the aorta, known to be susceptible for atherosclerosis, were characterized by high time averaged WSS and high oscillatory shear index.Finally, the predictive capability of CFD was investigated. An idealized model of a human aorta with a coarctation and post-stenotic dilatation was studied before and after a possible repair of the constriction. The results suggested that iii small remaining abnormalities in the geometry may deteriorate the chances for a successful treatment. Also, high values of shear rate and Reynolds stresses were found in the dilatation after the constriction, which previous works have shown means increased risk for thrombus formation and hemolysis. iv Populärvetenskaplig be...

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“…The three main factors that determine the intensity of the thrombotic response to rupture are: 1) rupture extension and composition of plaque contents [58][59][60] ; 2) the degree of stenosis and irregularity of the plaque surface 61,62 ; 3) balance between thrombotic and thrombolytic factors at the moment of rupture [63][64][65][66][67] . In the majority of patients with unstable angina, plaque erosion or rupture resolves with the vascular reparation process that results in an increase of the degree of obstruction.…”

Section: Clinical Repercussions Of Plaque Rupturementioning

confidence: 99%

Acute ischemic syndromes

Fd¹

1999

Arq. Bras. Cardiol.

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Synergistic action of severe wall injury and shear forces on thrombus formation in arterial stenosis: Definition of a thrombotic shear rate threshold

Abstract: In low shear rate conditions, deep arterial injury will lead to mural thrombosis without further thrombus growth. When deep arterial injury occurs under critical local shear conditions, platelet deposition will be enhanced, and thrombosis may progress to total occlusion.

Cited by 47 publications

References 28 publications

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Turbulent Flow in Constricted Blood Vessels : Quantification of Wall Shear Stress Using Large Eddy Simulation

Acute ischemic syndromes

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