Numerical Study of Blood Clots Influence on the Flow Pattern and Platelet Activation on a Stented Bifurcation Model

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Computational Fluid Dynamics

Background:

• Stent implantation is crucial for treating atherosclerosis but can lead to complications like blood clot formation on stent struts.
• These thrombus depositions can significantly alter blood flow patterns, particularly in complex geometries like stented bifurcations.
• Understanding these flow modifications is vital for improving patient outcomes after stenting.

Purpose of the Study:

• To numerically investigate the impact of blood clot deposition on stent struts within a stented coronary bifurcation.
• To analyze the effects of thrombus presence on hemodynamic parameters and platelet activation.
• To evaluate how varying geometric configurations influence these outcomes.

Main Methods:

• A numerical model was developed and validated against experimental measurements of artificial thrombi deposition on stent struts.
• Simulations were performed to assess changes in Time Averaged Wall Shear Stress (T AWSS), Oscillatory Shear Index (OSI), and Relative Residence Time (RRT).
• Platelet activation was studied across different geometric models, from straight tubes to stented bifurcations with thrombus.

Main Results:

• Thrombus deposition on stent struts demonstrably alters key hemodynamic parameters.
• The presence of thrombi significantly influences platelet activation, with effects varying based on stent geometry.
• Complex bifurcation geometries exacerbate the hemodynamic consequences of thrombus accumulation.

Conclusions:

• Blood clot deposition on coronary stents critically impacts hemodynamics and platelet activation.
• Numerical simulations provide valuable insights into stenting-related complications, particularly in bifurcations.
• Further research into optimizing stent design and deployment strategies is warranted to mitigate these risks.