Accession Number : AD1015577


Title :   Computational Study of Thrombus Formation and Clotting Factor Effects under Venous Flow Conditions


Descriptive Note : Journal Article


Corporate Author : ARMY MEDICAL RESEARCH AND MATERIEL COMMAND FORT DETRICK MD FORT DETRICK United States


Personal Author(s) : Govindarajan,Vijay ; Rakesh,Vineet ; Reifman,Jaques ; Mitrophanov,Alexander Y


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/1015577.pdf


Report Date : 26 Apr 2016


Pagination or Media Count : 17


Abstract : A comprehensive understanding of thrombus formation as a physicochemical process that has evolved to protect the integrity of the human vasculature is critical to our ability to predict and control pathological states caused by a malfunctioning blood coagulation system. Despite numerous investigations, the spatial and temporal details of thrombus growth as a multicomponent process are not fully understood. Here, we used computational modeling to investigate the temporal changes in the spatial distributions of the key enzymatic (i.e., thrombin) and structural (i.e., platelets and fibrin) components within a growing thrombus. Moreover, we investigated the interplay between clot structure and its mechanical properties, such as hydraulic resistance to flow. Our model relied on the coupling of computational fluid dynamics and biochemical kinetics, and was validated using flow-chamber data from a previous experimental study. The model allowed us to identify the distinct patterns characterizing the spatial distributions of thrombin, platelets, and fibrin accumulating within a thrombus. Our modeling results suggested that under the simulated conditions, thrombin kinetics was determined predominantly by prothrombinase. Furthermore, our simulations showed that thrombus resistance imparted by fibrin was 30-fold higher than that imparted by platelets. Yet, thrombus-mediated blood flow occlusion was driven primarily by the platelet deposition process, because the height of the platelet accumulation domain was approximately twice that of the fibrin accumulation domain. Fibrinogen supplementation in normal blood resulted in a nonlinear increase in thrombus resistance, and for a supplemented fibrinogen level of 48%, the thrombus resistance increased by 2.7-fold. Finally, our model predicted that restoring the normal levels of clotting factors II, IX, and X while simultaneously restoring fibrinogen (to 88% of its normal level) in diluted blood can restore fibrin generation to 78%


Descriptors :   blood coagulation factors , computational modeling , mechanical properties , computational fluid dynamics , chemical kinetics , fluid flow , spatial distribution , BLOOD PLATELETS , fibrin , accumulation , resistance , biochemistry , dilution


Distribution Statement : APPROVED FOR PUBLIC RELEASE