Key result
A 2D computational model successfully predicted the spatial and temporal evolution of platelet plug formation, confirming the importance of both mechanical and chemical aggregation of platelets.
Why the study?
Thrombotic deposition is a major consideration in cardiovascular device development, and localized shear gradients play a critical role in thrombogenesis, but computational models lacked integration of shear gradient effects.
Hypothesis-generating for multiscale thrombosis models; leaves open clinical translation pending experimental validation.
Objectives Thrombotic deposition is a major consideration in the development of implantable cardiovascular devices. Recently, it has been experimentally demonstrated that localized changes in the blood shear rate -i.e. shear gradients-play a critical role in thrombogenesis. The goal of the present work is to develop a predictive computational model of platelet plug formation that can be used to assess the thrombotic burden of cardiovascular devices, introducing for the first time the role of shear gradients. We have developed a comprehensive model of platelet-mediated thrombogenesis which includes platelet transport in the blood flow, platelet activation and aggregation induced by both biochemical and mechanical factors, kinetics and mechanics of platelet adhesion, and changes in the local fluid dynamics due to the thrombus growth. Methods A 2D computational model was developed using the multi-physics finite element solver COMSOL 5.6. The model can be described by a coupled set of convection-diffusion-reaction equations. Platelet adhesion at the surface was modeled via flux boundary conditions. Using a moving mesh for the surface, thrombus growth and consequent alterations in blood flow were modeled. In the case of a stenosis, the notions of shear stress induced platelet activation in the contraction zone and shear gradients induced platelet deposition in the expansion zone downstream of the stenosis were studied. Results The model provides the spatial and temporal evolution of platelet plug in the flow field. The computed platelet plug size evolution was validated against literature data. The results confirm the importance of considering both mechanical and chemical aggregation of platelets. Conclusions The developed model represents a potentially useful tool for the optimization of the design of the cardiovascular device flow path.
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Cardillo et al. (2023) studied Thrombosis. 2D computational model of platelet-mediated thrombogenesis was evaluated on Spatial and temporal evolution of platelet plug in the flow field. A 2D computational model successfully predicted the spatial and temporal evolution of platelet plug formation, confirming the importance of both mechanical and chemical aggregation of platelets.
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