Key result
Mathematical modeling reveals two hydrodynamic thresholds for blood coagulation activation, suggesting relatively small plaques (<50% lumen reduction) play a significant role in atherothrombosis.
Mathematical modeling demonstrates that shear stress-induced permeability can initiate coagulation even in relatively small plaques (<50% lumen reduction), potentially challenging current stenting guidelines.
May implicate milder stenoses in atherothrombosis; leaves open whether stenting thresholds warrant reevaluation.
Increased shear stress such as observed at local stenosis may cause drastic changes in the permeability of the vessel wall to procoagulants and thus initiate intravascular blood coagulation. In this paper we suggest a mathematical model to investigate how shear stress-induced permeability influences the thrombogenic potential of atherosclerotic plaques. Numerical analysis of the model reveals the existence of two hydrodynamic thresholds for activation of blood coagulation in the system and unveils typical scenarios of thrombus formation. The dependence of blood coagulation development on the intensity of blood flow, as well as on geometrical parameters of atherosclerotic plaque is described. Relevant parametric diagrams are drawn. The results suggest a previously unrecognized role of relatively small plaques (resulting in less than 50% of the lumen area reduction) in atherothrombosis and have important implications for the existing stenting guidelines.
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Rukhlenko et al. (2015) studied Intravascular blood coagulation. Wall shear stress was evaluated on Hydrodynamic thresholds for activation of blood coagulation. Mathematical modeling reveals two hydrodynamic thresholds for blood coagulation activation, suggesting relatively small plaques (<50% lumen reduction) play a significant role in atherothrombosis.
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