Peridynamics coupled computational fluid dynamics as a paradigm for simulating problems involving fracture of thrombi under fluid flow: Demonstration in aspiration thrombectomy

Aspiration thrombectomy is a widely used interventional strategy for restoring flow in thrombus-occluded blood vessels. Predicting and improving outcomes of this procedure requires resolving the complex interplay between thrombus heterogeneity, large structure deformation, fracture mechanics, and hemodynamics. In this work, we demonstrate the viability of our previously developed coupled Peridynamics-Computational Fluid Dynamics (PD-CFD) framework as a paradigm for simulating aspiration thrombectomy of a partially occlusive clot in a bifurcation. Parametric studies varying suction velocity, catheter diameter, and clot material properties captured a range of aspiration outcomes — including incomplete retrieval, partial ingestion with fragmentation, and complete ingestion under near-choked flow conditions. Variation of suction velocity indicated the existence of a minimum suction velocity threshold beyond which the clot is essentially fully ingested. By capturing common clinical outcomes while simultaneously resolving the intricate physics of fluid-induced thrombus fracture from first principles, these results establish PD-CFD as a viable numerical paradigm for studying the coupled physics of thrombotic interventions and motivate its extension to anatomically realistic geometries and calibrated clot properties in future work.