Thrombus formation on apex of arterial stenoses: the need for a fluid high shear stenosis diagnostic device.

This review is focused upon the studies of thrombus formation in human non-anticoagulated blood on an apex of an eccentric stenosis positioned in the blood flow channel of a parallel-plate perfusion chamber. Thrombus formation in blood from healthy individuals and patients with various bleeding disorders, as well as the effects of a diet supplement and pharmacological interventions, are discussed in view of thrombus-forming mechanisms under these complex blood-flow conditions. Hallmarks of this significantly enhanced thrombus formation are the apparent dependence on thrombin generation, shear-induced platelet activation, induction of platelet procoagulant activity and pronounced platelet microparticle formation that parallel the growth of these fibrin-rich thrombi. The development of miniature models of these blood-flow devices for diagnostic purposes is suggested for the assessment and monitoring of the efficacy of antithrombotic regimens in blood from patients with atherosclerotic disease in parallel with assessments of platelet microparticle formation, shear-induced platelet activation and platelet procoagulant activity.