Towards Non-thrombogenic Performance of Blood Recirculating Devices
Towards Non-thrombogenic Performance of Blood Recirculating Devices
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DOI：
10.1007/s10439-010-9905-9
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发表时间：
2010-03-01
影响因子：
3.8
通讯作者：
Manning, K. B.
中科院分区：
文献类型：
--
作者：
Bluestein, D.;Chandran, K. B.;Manning, K. B.
植入式血液再循环装置为患有严重心血管疾病的患者提供了挽救生命的解决方案。然而，溶血和血栓栓塞的常见问题仍然是这些装置的障碍。在这篇文章中，我们提出了一个简短的审查工作的几个小组在该领域，导致了新的方法，可能有助于实现艰巨的目标，优化血液再循环装置的血栓形成性能的发展。目的是描述与流动诱导应力和血液成分之间的相互作用有关的工作，并支持以下假设：人工血液再循环装置中的血栓栓塞主要由非生理性流动模式和应力引发和维持，这些流动模式和应力激活并增强血小板聚集，增加血栓栓塞和心源性卒中的风险。这些工作包括最先进的数值和实验工具，用于阐明导致假体装置血栓栓塞的流动诱导机制。在回顾之后，本文描述了一些活跃在该领域的团体所做的一些努力，并指出了未来应该追求的几个方向，以实现血液再循环假体装置在未来成为更有效的目的地治疗的目标。
Implantable blood recirculating devices have provided life saving solutions to patients with severe cardiovascular diseases. However, common problems of hemolysis and thromboembolism remain an impediment to these devices. In this article, we present a brief review of the work by several groups in the field that has led to the development of new methodologies that may facilitate achieving the daunting goal of optimizing the thrombogenic performance of blood recirculating devices. The aim is to describe work which pertains to the interaction between flow-induced stresses and the blood constituents, and that supports the hypothesis that thromboembolism in prosthetic blood recirculating devices is initiated and maintained primarily by the non-physiological flow patterns and stresses that activate and enhance the aggregation of blood platelets, increasing the risk of thromboembolism and cardioembolic stroke. Such work includes state-of-the-art numerical and experimental tools used to elucidate flow-induced mechanisms leading to thromboembolism in prosthetic devices. Following the review, the paper describes several efforts conducted by some of the groups active in the field, and points to several directions that should be pursued in the future in order to achieve the goal for blood recirculating prosthetic devices becoming more effective as destination therapy in the future.