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A computational model-based study on the feasibility of predicting post-splenectomy thrombosis using hemodynamic
Tianqi Wang1,2, Yan Yong3, Xinyang Ge4
1School of Gongli Hospital Medical Technology, University of Shanghai for Science and Technology, Shanghai, China.
Frontiers in Bioengineering and Biotechnology
|January 26, 2024
Summary
Computational models can predict post-splenectomy thrombosis in portal hypertensive patients. The area of low wall shear stress (ALWSS) effectively identifies patients at risk, aiding in prophylaxis and management.
Area of Science:
- Medical Imaging and Computational Fluid Dynamics
- Vascular Surgery and Thrombosis Research
- Hepatology and Portal Hypertension Management
Background:
- Splenectomy is crucial for managing portal hypertension complications like splenomegaly and hypersplenism.
- Post-splenectomy portal venous system thrombosis is a serious risk requiring effective prediction and prophylaxis.
- Current methods for predicting thrombosis post-splenectomy require enhancement.
Purpose of the Study:
- To assess the feasibility of predicting post-splenectomy thrombosis using computational hemodynamic metrics.
- To investigate the correlation between computational models and clinical outcomes.
- To identify novel predictive markers for post-splenectomy thrombosis.
Main Methods:
- Construction of patient-specific computational models of the portal venous system using CT angiography and ultrasound data.
- Simulation of splenectomy and analysis of the resulting area of low wall shear stress (ALWSS).
- Statistical comparison of simulated ALWSS with clinical follow-up data to predict thrombosis.
Main Results:
- The simulated ALWSS demonstrated a significant predictive capability for post-splenectomy thrombosis (AUC = 0.75).
- Splenic vein diameter showed a strong positive correlation with ALWSS (r = 0.883, p < 0.0001).
- Anatomical variations within the portal venous system were found to influence ALWSS.
Conclusions:
- Computational hemodynamic metrics, specifically ALWSS, can effectively predict post-splenectomy thrombosis.
- ALWSS is influenced by patient-specific anatomorphological features of the portal venous system.
- This approach offers a promising tool for improved prophylaxis and postoperative management in patients undergoing splenectomy for portal hypertension.
