Modeling of Acute Ischemic Stroke for Improving Mechanical Thrombectomy

摘要 对于美国每年估计发生的700,000例急性缺血性中风(AIS)，新的支架 取回器设备显示，闭塞的大脑动脉再通率增加。然而，超过15%的 血栓栓子仍无法清除，另有17%的患者在90天内死亡，尽管 成功的再通畅。到目前为止，对上游血栓形成和栓塞术知之甚少。 导致AIS的过程，以及为什么一些血栓栓子被成功移除，而另一些却没有。至 为了更好地了解AIS的整个发展过程，我们将开发上游的计算模型 血栓形成、血栓栓塞、脑血管倒伏和粘连，以及通过外用药物清除 来自血栓摘除装置的力量。这些模型将通过体外模拟循环流环进行验证。 这使得能够实时跟踪血栓生长和栓塞术，并在 生理上准确的场景。此外，还将使用患者特有的解剖和血液化学方法。 这些研究的结果将为AIS的闭塞提供洞察力，但也提供了一个全面改善的机会 病人的结果。

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.