Computational simulation of platelet interactions in the initiation of stent thrombosis due to stent malapposition.
Computational simulation of platelet interactions in the initiation of stent thrombosis due to stent malapposition.
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DOI：
10.1088/1478-3975/13/1/016001
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发表时间：
2016-01-20
期刊：
影响因子：
2
通讯作者：
Han HC
中科院分区：
文献类型：
--
作者：
Chesnutt JK;Han HC
冠状动脉支架植入术是治疗动脉粥样硬化闭塞的最常用方法之一。支架贴壁不良可诱导血栓形成，但对微观过程了解甚少。本研究的目的是确定不同程度的支架贴壁不良影响支架血栓形成的血小板水平过程。我们利用离散元模型来计算模拟支架冠状动脉血栓形成过程中数千个血小板和红细胞的运输、粘附和活化。模拟动脉含有贴壁不良支架，支柱和内皮之间具有规定的间隙距离（0、10、25、50或200 μm）。在模拟过程中测量了最近端支柱附近血栓形成的血小板水平细节。间隙距离和动脉中血栓量之间的关系根据不同的条件而变化（例如，内皮功能障碍的量、剪切诱导的血小板活化和支柱的血栓形成性）。在不考虑剪切诱导的血小板活化的情况下，最大间隙距离（200 μm）未产生再循环，且血栓少于在支柱下游产生再循环的最小两个间隙距离（0和10 μm）。然而，随着剪切诱导血小板活化的发生，最大间隙距离产生的血栓多于两个最小间隙距离，但血栓少于中间间隙距离（25 μm）。与一些计算流体动力学研究的影响相反，大的间隙距离不一定是最易形成血栓的。支架贴壁不良的严重程度对初始支架血栓形成的影响不同，这取决于与液体再循环、血小板轨迹、剪切应力和内皮条件相关的各种因素。
Coronary stenting is one of the most commonly used approaches to open coronary arteries blocked due to atherosclerosis. Stent malapposition can induce thrombosis but the microscopic process is poorly understood. The objective of this study was to determine the platelet-level process by which different extents of stent malapposition affect the initiation of stent thrombosis. We utilized a discrete element model to computationally simulate the transport, adhesion, and activation of thousands of individual platelets and red blood cells during thrombus initiation in stented coronary arteries. Simulated arteries contained a malapposed stent with a specified gap distance (0, 10, 25, 50, or 200 μm) between the struts and endothelium. Platelet-level details of thrombus formation near the proximal-most strut were measured during the simulations. The relationship between gap distance and amount of thrombus in the artery varied depending on different conditions (e.g., amount of dysfunctional endothelium, shear-induced activation of platelets, and thrombogenicity of the strut). Without considering shear-induced platelet activation, the largest gap distance (200 μm) produced no recirculation and less thrombus than the smallest two gap distances (0 and 10 μm) that created recirculation downstream of the strut. However, with the occurrence of shear-induced platelet activation, the largest gap distance produced more thrombus than the two smallest gap distances, but less thrombus than an intermediate gap distance (25 μm). A large gap distance was not necessarily the most thrombogenic, in contrast to implications of some computational fluid dynamics studies. The severity of stent malapposition affected initial stent thrombosis differently depending on various factors related to fluid recirculation, platelet trajectories, shear stress, and endothelial condition.
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影响因子：
4.4
作者：
Flamm, Matthew H.;Sinno, Talid;Diamond, Scott L.
通讯作者：
Diamond, Scott L.
DOI：
10.1098/rspb.1988.0038
发表时间：
1988-06-22
期刊：
PROCEEDINGS OF THE ROYAL SOCIETY SERIES B-BIOLOGICAL SCIENCES
影响因子：
--
作者：
DEMBO, M;TORNEY, DC;HAMMER, D
通讯作者：
HAMMER, D
影响因子：
3.8
作者：
Bluestein, D;Niu, LJ;Dewanjee, MK
通讯作者：
Dewanjee, MK
影响因子：
3.8
作者：
Chesnutt, J. K. W.;Marshall, J. S.
通讯作者：
Marshall, J. S.
影响因子：
1.8
作者：
Casa, Lauren D. C.;Ku, David N.
通讯作者：
Ku, David N.