Ngoepe Malebogo N, Pretorius Etheresia, Tshimanga Ilunga J, Shaikh Zahra, Ventikos Yiannis, Ho Wei Hua
Department of Mechanical Engineering, University of Cape Town, Cape Town, South Africa.
Stellenbosch Institute for Advanced Study, Wallenberg Research Centre, Stellenbosch University, Stellenbosch, South Africa.
TH Open. 2021 May 12;5(2):e155-e162. doi: 10.1055/s-0041-1728790. eCollection 2021 Apr.
Cerebral aneurysms are balloon-like structures that develop on weakened areas of cerebral artery walls, with a significant risk of rupture. Thrombi formation is closely associated with cerebral aneurysms and has been observed both before and after intervention, leading to a wide variability of outcomes in patients with the condition. The attempt to manage the outcomes has led to the development of various computational models of cerebral aneurysm thrombosis. In the current study, we developed a simplified thrombin-fibrinogen flow system, based on commercially available purified human-derived plasma proteins, which enables thrombus growth and tracking in an idealized cerebral aneurysm geometry. A three-dimensional printed geometry of an idealized cerebral aneurysm and parent vessel configuration was developed. An unexpected outcome was that this phantom-based flow model allowed us to track clot growth over a period of time, by using optical imaging to record the progression of the growing clot into the flow field. Image processing techniques were subsequently used to extract important quantitative metrics from the imaging dataset, such as end point intracranial thrombus volume. The model clearly demonstrates that clot formation, in cerebral aneurysms, is a complex interplay between mechanics and biochemistry. This system is beneficial for verifying computational models of cerebral aneurysm thrombosis, particularly those focusing on initial angiographic occlusion outcomes, and will also assist manufacturers in optimizing interventional device designs.
脑动脉瘤是在脑动脉壁薄弱区域形成的气球样结构,具有很高的破裂风险。血栓形成与脑动脉瘤密切相关,在干预前后均有观察到,导致该疾病患者的预后差异很大。为了控制预后,人们开发了各种脑动脉瘤血栓形成的计算模型。在本研究中,我们基于市售的纯化人源血浆蛋白开发了一种简化的凝血酶-纤维蛋白原流动系统,该系统能够在理想化的脑动脉瘤几何形状中实现血栓生长和追踪。我们构建了理想化脑动脉瘤及其母血管构型的三维打印模型。一个意外的结果是,这种基于模型的流动模型使我们能够通过光学成像记录不断生长的血栓进入流场的过程,从而在一段时间内追踪血栓的生长。随后使用图像处理技术从成像数据集中提取重要的定量指标,如颅内血栓终末体积。该模型清楚地表明,脑动脉瘤中的血栓形成是力学和生物化学之间复杂的相互作用。该系统有助于验证脑动脉瘤血栓形成的计算模型,特别是那些关注初始血管造影闭塞结果模型,也将帮助制造商优化介入设备设计。