GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland.
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Proc Inst Mech Eng H. 2020 Dec;234(12):1421-1431. doi: 10.1177/0954411920946873. Epub 2020 Aug 5.
Atrial fibrillation is the most significant contributor to thrombus formation within the heart and is responsible for 45% of all cardio embolic strokes, which account for approximately 15% of acute ischemic strokes cases worldwide. Atrial fibrillation can result in a reduction of normal cardiac output and cycle length of up to 30% and 40%, respectively. A total of 240 embolus analogues were released into a thin-walled, patient-specific aortic arch under normal (60 embolus analogues) and varying atrial fibrillation (180 embolus analogues) pulsatile flow conditions. Under healthy flow conditions (n = 60), the embolus analogues tended to follow the flow rate split through each outlet vessel. There was an increase in clot trajectories along the common carotid arteries under atrial fibrillation flow conditions. A shorter pulse period (0.3 s) displayed the highest percentage of clots travelling to the brain (24%), with a greater percentage of clots travelling through the left common carotid artery (17%). This study provides an experimental insight into the effect varying cardiac output and cycle length can have on the trajectory of a cardiac source blood clots travelling to the cerebral vasculature and possibly causing a stroke.
心房颤动是导致心脏内血栓形成的最重要因素，占所有心源性栓塞性中风的 45%，约占全球急性缺血性中风病例的 15%。心房颤动可导致正常心输出量和心动周期分别减少 30%和 40%。在正常（60 个栓塞模拟物）和不同的心房颤动（180 个栓塞模拟物）脉动流条件下，总共将 240 个栓塞模拟物释放到薄壁、患者特异性的主动脉弓中。在健康的血流条件下（n=60），栓塞模拟物倾向于跟随每个出口血管的流速分配。在心房颤动血流条件下，沿颈总动脉的血栓轨迹增加。较短的脉冲周期（0.3s）显示有 24%的血栓前往大脑，通过左颈总动脉的血栓比例更高（17%）。这项研究提供了一个实验性的见解，了解不同的心输出量和心动周期对前往脑血管并可能导致中风的心脏来源血栓轨迹的影响。
