Why the study?
Does simulated walking alter wall shear stress in a patient with deep venous thrombosis?
Does simulated walking alter wall shear stress in a patient with deep venous thrombosis?
Computational modeling suggests that walking-induced muscle changes decrease wall shear stress by up to 10% in DVT, though blood viscosity and flow rate may have greater impacts.
Simulated walking may alter WSS via muscle length in DVT; leaves open clinical relevance and requires prospective validation.
Deep venous thrombosis (DVT) is a common disease. Large thrombi in venous vessels cause bad blood circulation and pain; and when a blood clot detaches from a vein wall, it causes an embolism whose consequences range from mild to fatal. Walking is recommended to DVT patients as a therapeutical complement. In this study the mechanical effects of walking on a specific patient of DVT were simulated by means of an unprecedented integration of 3 elements: a real geometry, a biomechanical model of body tissues, and a computational fluid dynamics study. A set of computed tomography images of a patient's leg with a thrombus in the popliteal vein was employed to reconstruct a geometry model. Then a biomechanical model was used to compute the new deformed geometry of the vein as a function of the fiber stretch level of the semimembranosus muscle. Finally, a computational fluid dynamics study was performed to compute the blood flow and the wall shear stress (WSS) at the vein and thrombus walls. Calculations showed that either a lengthening or shortening of the semimembranosus muscle led to a decrease of WSS levels up to 10%. Notwithstanding, changes in blood viscosity properties or blood flow rate may easily have a greater impact in WSS.
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López et al. (2016) studied this question.
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