CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310, Vigo, Spain.
Engineering Faculty of University of Porto, Institute of Science and Innovation in Mechanical and Industrial Engineering (LAETA-INEGI), Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.
Cardiovasc Eng Technol. 2023 Aug;14(4):544-559. doi: 10.1007/s13239-023-00672-4. Epub 2023 Jul 19.
There are still many challenges for modelling a thrombus migration process in aneurysms. The main novelty of the present research lies in the modelling of aneurysm clot migration process in a realistic cerebral aneurysm, and the analysis of forces suffered by clots inside an aneurysm, through transient FSI simulations.
The blood flow has been modelled using a Womersley velocity profile, and following the Carreau viscosity model. Hyperelastic Ogden model has been used for clot and isotropic linear elastic model for the artery walls. The FSI coupled model was implemented in ANSYS® software. The hemodynamic forces suffered by the clot have been quantified using eight different clot sizes and positions inside a real aneurysm.
The obtained results have shown that it is almost impossible for clots adjacent to aneurysm walls, to leave the aneurysm. Nevertheless, in clots positioned in the centre of the aneurysm, there is a real risk of clot migration. The risk of migration of a typical post-coiling intervention clot in an aneurysm, in contact with the wall and occupying a significant percentage of its volume is very low in the case studied, even in the presence of abnormally intense events, associated with sneezes or impacts.
The proposed methodology allows evaluating the clot migration risk, vital for evaluating the progress after endovascular interventions, it is a step forward in the personalized medicine, patient follow-up, and helping the medical team deciding the optimal treatment.
在动脉瘤中模拟血栓迁移过程仍然存在许多挑战。本研究的主要新颖之处在于在真实的脑动脉瘤中对动脉瘤血栓迁移过程进行建模,并通过瞬态流固耦合模拟分析动脉瘤内血栓所受的力。
血流采用沃默斯利速度分布进行建模,并遵循卡劳伊粘度模型。超弹性 Ogden 模型用于血栓,各向同性线弹性模型用于动脉壁。FSI 耦合模型在 ANSYS 软件中实现。使用八种不同的血栓大小和位置在真实动脉瘤内,对血栓所受的血流动力进行量化。
所得结果表明,紧邻动脉瘤壁的血栓几乎不可能离开动脉瘤。然而,在位于动脉瘤中心的血栓中,确实存在血栓迁移的风险。在研究案例中,与壁接触并占据其体积较大比例的典型血管内线圈介入后血栓的迁移风险非常低,即使存在打喷嚏或撞击等异常剧烈的事件也是如此。
所提出的方法可以评估血栓迁移风险,这对于评估血管内介入治疗后的进展至关重要,它是个性化医学、患者随访和帮助医疗团队决定最佳治疗方案的重要一步。