颅内动脉瘤分流装置上的纤维蛋白聚集模型。

IF 2.2 4区 医学 Q3 ENGINEERING, BIOMEDICAL International Journal for Numerical Methods in Biomedical Engineering Pub Date : 2024-11-05 DOI:10.1002/cnm.3883
Juan R Cebral, Fernando Mut, Rainald Löhner, Laurel Marsh, Alireza Chitsaz, Cem Bilgin, Esref Bayraktar, David Kallmes, Ramanathan Kadirvel
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引用次数: 0

摘要

使用分流装置治疗后导致动脉瘤闭塞的机制尚未完全明了。血流改变会诱导动脉瘤腔内血栓形成,但纤维蛋白会同时积聚并覆盖装置支架,导致血流进一步改变。然而,人们对这些过程的相互作用和相对重要性并不清楚。在体外实验和观察的指导下,我们建立了脑动脉瘤血流分流治疗后纤维蛋白积聚和血流改变的计算模型。该模型基于流动和传输-反应方程的松散耦合,这些方程由独立的代码分别求解。相互作用或反应项解释了凝血酶原在血栓形成金属丝的刺激下产生凝血酶和抗凝血酶的抑制作用,以及纤维蛋白原在凝血酶和流动剪应力的刺激下产生纤维蛋白,以及纤维蛋白粘附到装置金属丝和已经附着的纤维蛋白上。计算模型在理想化的血管和动脉瘤几何形状上进行了演示和测试。该模型能够再现在理想化的体外脑动脉瘤模型中部署导流装置后纤维蛋白积聚的显著特点。即,在高剪切应力区域产生纤维蛋白、在流入区初始积聚、装置逐渐闭塞以及相应的血流衰减。将流动动力学与纤维蛋白的产生、运输和粘附联系起来的计算模型可用于研究和更好地理解导致纤维蛋白积聚的效应,以及由此引起的动脉瘤流入量减少和动脉瘤内血流调节。
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Modeling Fibrin Accumulation on Flow-Diverting Devices for Intracranial Aneurysms.

The mechanisms leading to aneurysm occlusion after treatment with flow-diverting devices are not fully understood. Flow modification induces thrombus formation within the aneurysm cavity, but fibrin can simultaneously accumulate and cover the device scaffold, leading to further flow modification. However, the interplay and relative importance of these processes are not clearly understood. A computational model of fibrin accumulation and flow modification after flow diversion treatment of cerebral aneurysms has been developed under the guidance of in vitro experiments and observations. The model is based on the loose coupling of flow and transport-reaction equations that are solved separately by independent codes. Interaction or reactive terms account for thrombin production from prothrombin stimulated by thrombogenic metallic wires and inhibition by antithrombin as well as fibrin production from fibrinogen stimulated by thrombin and flow shear stress, and fibrin adhesion to device wires and already attached fibrin. The computational model was demonstrated and tested on idealized vessel and aneurysm geometries. The model was able to reproduce the salient features of fibrin accumulation after the deployment of flow-diverting devices in idealized in vitro models of cerebral aneurysms. Namely, fibrin production in regions of high shear stress, initial accumulation at the inflow zone, and progressive occlusion of the device and corresponding flow attenuation. The computational model linking flow dynamics to fibrin production, transport, and adhesion can be used to investigate and better understand the effects that lead to fibrin accumulation and the resulting aneurysm inflow reduction and intra-aneurysmal flow modulation.

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来源期刊
International Journal for Numerical Methods in Biomedical Engineering
International Journal for Numerical Methods in Biomedical Engineering ENGINEERING, BIOMEDICAL-MATHEMATICAL & COMPUTATIONAL BIOLOGY
CiteScore
4.50
自引率
9.50%
发文量
103
审稿时长
3 months
期刊介绍: All differential equation based models for biomedical applications and their novel solutions (using either established numerical methods such as finite difference, finite element and finite volume methods or new numerical methods) are within the scope of this journal. Manuscripts with experimental and analytical themes are also welcome if a component of the paper deals with numerical methods. Special cases that may not involve differential equations such as image processing, meshing and artificial intelligence are within the scope. Any research that is broadly linked to the wellbeing of the human body, either directly or indirectly, is also within the scope of this journal.
期刊最新文献
Therapeutic Effect of Targeted Deployment Filling Coils in the Treatment of Intracranial Aneurysms. Modeling Fibrin Accumulation on Flow-Diverting Devices for Intracranial Aneurysms. A comparison of machine learning methods for recovering noisy and missing 4D flow MRI data. A semi-automatic method for block-structured hexahedral meshing of aortic dissections. Fluid-structure interaction analysis of a healthy aortic valve and its surrounding haemodynamics.
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