Modeling of Acute Ischemic Stroke for Improving Mechanical Thrombectomy

总结 据估计，美国每年发生70万例急性缺血性卒中（AIS）， 回收器装置已经显示出增加了闭塞的脑动脉的再通。然而，超过15% 的血栓栓塞仍然无法清除，另有17%的患者在90天内死亡， 成功再通。迄今为止，对上游血栓形成和栓塞的了解很少 导致AIS的过程以及为什么一些血栓栓塞被成功清除而另一些则没有。到 为了更好地了解AIS的整个进展，我们将开发上游的计算模型， 血栓形成、血栓栓塞、脑血管系统中的倒伏和粘连，以及通过应用 血栓切除器械的作用力。这些模型将使用离体模拟循环流动回路进行验证 这使得能够实时跟踪血栓生长和栓塞，并模拟AIS闭塞， 生理上准确的场景。此外，将使用患者特定解剖结构和血液化学。 这些研究的结果将为AIS闭塞提供深入了解，但也为总体改善提供了机会 患者结局。

Summary For the estimated 700,000 acute ischemic strokes (AIS) that occur each year in the United States, new stent retriever devices have shown an increase in recanalization of occluded cerebral arteries. However, over 15% of thromboemboli are still unable to be cleared and another 17% of patients die within 90 days despite successful recanalization. To date, there is little understanding of the upstream thrombosis and embolization processes that lead to AIS and why some thromboemboli are successfully removed and others are not. To better understand the entire progression of AIS, we will develop computational models of the upstream thrombosis, thrombus embolization, lodging and adhesion in the cerebral vasculature, and removal via applied forces from a thrombectomy device. These models will be validated with ex vivo mock circulatory flow loops that enable real-time tracking of thrombus growth and embolization and for AIS occlusion to be simulated in physiologically accurate scenarios. Furthermore, patient-specific anatomy and blood chemistry will be used. The results of these studies will provide insight to AIS occlusion but provide an opportunity to improve overall patient outcomes.