Sarrami-Foroushani, A, Lassila, T orcid.org/0000-0001-8947-1447, Hejazi, SM et al. (3 more authors) (2019) A computational model for prediction of clot platelet content in flow-diverted intracranial aneurysms. Journal of Biomechanics, 91. pp. 7-13. ISSN 0021-9290
Abstract
Treatment of intracranial aneurysms with flow-diverting stents is a safe and minimally invasive technique. The goal is stable embolisation that facilitates stent endothelialisation, and elimination of the aneurysm. However, it is not fully understood why some aneurysms fail to develop a stable clot even with sufficient levels of flow reduction. Computational prediction of thrombus formation dynamics can help predict the post-operative response in such challenging cases. In this work, we propose a new model of thrombus formation and platelet dynamics inside intracranial aneurysms. Our novel contribution combines platelet activation and transport with fibrin generation, which is key to characterising stable and unstable thrombus. The model is based on two types of thrombus inside aneurysms: red thrombus (fibrin- and erythrocyte-rich) can be found in unstable clots, while white thrombus (fibrin- and platelet-rich) can be found in stable clots. The thrombus generation model is coupled to a CFD model and the flow-induced platelet index (FiPi) is defined as a quantitative measure of clot stability. Our model is validated against an in vitro phantom study of two flow-diverting stents with different sizing. We demonstrate that our model accurately predicts the lower thrombus stability in the oversized stent scenario. This opens possibilities for using computational simulations to improve endovascular treatment planning and reduce adverse events, such as delayed haemorrhage of flow-diverted aneurysms.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019, The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | flow diverter; intracranial aneurysms; thrombosis; computational fluid dynamics |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Computing (Leeds) |
Funding Information: | Funder Grant number EU - European Union 777119 |
Depositing User: | Symplectic Publications |
Date Deposited: | 02 May 2019 10:19 |
Last Modified: | 10 Nov 2021 16:09 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jbiomech.2019.04.045 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145578 |
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