Introducing the pro-coagulant contact system in the numerical assessment of device-related thrombosis
Introducing the pro-coagulant contact system in the numerical assessment of device-related thrombosis
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DOI：
10.1007/s10237-017-0994-3
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发表时间：
2018-06-01
影响因子：
3.5
通讯作者：
Nicoud, Franck
中科院分区：
文献类型：
--
作者：
Rojano, Rodrigo Mendez;Mendez, Simon;Nicoud, Franck
血栓形成是血液涂层医疗器械的主要问题。接触激活是器械相关血栓形成中凝血级联反应的初始部分，在当前血栓形成模型中未考虑。在本研究中，促凝反应，包括接触活化系统与流体求解器耦合，以评估接触系统启动凝血酶生产的潜力。生化/流体模型应用于面向后的台阶配置，这是一种经常出现在医疗器械中的流动配置。与体内血栓形成模型相反，在体内血栓形成模型中，特定的血栓形成区域（损伤区域）由用户先验地设定以启动凝血反应，反应性表面边界条件被应用于整个装置壁。模拟结果表明，大的凝血酶浓度在有关的再循环区的区域，而不需要一个先验知识的血栓位置。数值结果与文献中报道的实验结果中观察到的易于血栓形成的区域一致。这种方法可以补充考虑血小板活性和血栓生长的血栓形成模型，以优化各种医疗器械。
Thrombosis is a major concern in blood-coated medical devices. Contact activation, which is the initial part of the coagulation cascade in device-related thrombosis, is not considered in current thrombus formation models. In the present study, pro-coagulant reactions including the contact activation system are coupled with a fluid solver in order to evaluate the potential of the contact system to initiate thrombin production. The biochemical/fluid model is applied to a backward-facing step configuration, a flow configuration that frequently appears in medical devices. In contrast to the in vivo thrombosis models in which a specific thrombotic zone (injury region) is set a priori by the user to initiate the coagulation reaction, a reactive surface boundary condition is applied to the whole device wall. Simulation results show large thrombin concentration in regions related to recirculation zones without the need of an a priori knowledge of the thrombus location. The numerical results align well with the regions prone to thrombosis observed in experimental results reported in the literature. This approach could complement thrombus formation models that take into account platelet activity and thrombus growth to optimize a wide range of medical devices.