Analysis of shear stress and hemodynamic factors in a model of coronary artery stenosis and thrombosis.

Shear stress and alterations in blood flow within a stenosed artery promote platelet-dependent thrombosis. Using the Folts model of coronary thrombosis, we evaluated morphology, histology, and the hemodynamic properties of the stenosed vessel in 18 animals. The average stenosis created was 58 +/- 8%, with stenosed vessel diameters ranging from 0.084 to 0.159 cm. Histological examination of the stenosed vessel demonstrated that thrombi were composed primarily of platelets and formation occurred 1.0 mm downstream from the apex of the constriction, propagating distally. Peak shear stress occurred just upstream from the apex of the stenosis and varied from 520 to 3,349 dyn/cm2. Only small differences in shear forces were noted when blood viscosity was calculated using Newtonian and non-Newtonian properties. In contrast, shear stress computed for Poiseuille flow with use of the stenosis diameter underestimated the apical shear stress. Blood flow remained laminar within the stenosis with a Reynolds number range of 292-534. Our data indicate that the geometry of the stenosis inflow region must be considered in the evaluation of platelet activation and thrombus formation within a stenosed artery.