In vitro and ex vivo Flow Models for Arterial Thrombosis: A Systematic Review.

Area of Science:

• Cardiovascular Research
• Biomedical Engineering
• Hematology

Background:

• Arterial thrombosis involves platelet aggregation and fibrin deposition, leading to vessel occlusion and critical in cardiovascular diseases like heart attack and stroke.
• Understanding arterial thrombosis mechanisms is vital for developing effective preventative treatments and reducing disease burden.
• In vitro and ex vivo flow-based models are essential tools for studying thrombus formation under controlled conditions.

Purpose of the Study:

• To systematically review and classify in vitro and ex vivo flow-based models used for studying arterial thrombosis.
• To evaluate the design, physiological relevance, and experimental utility of these models.
• To provide a comprehensive overview for researchers investigating arterial thrombosis.

Main Methods:

• A systematic literature search was performed across Medline, Embase, and Web of Science using terms for arterial thrombosis and flow/shear stress models.
• Two independent reviewers screened articles, including studies with dynamic flow in vitro or ex vivo models.
• Eighty-two studies met the inclusion criteria, excluding static, venous, or in vivo models.

Main Results:

• Macro-scale models replicate complex arterial flow and thrombus formation similar to clinical findings.
• Microfluidic models offer precise control over shear stress and geometry, ideal for high-resolution imaging and patient-specific designs.
• Both model types have limitations in replicating in vivo hemodynamics but provide valuable platforms for mechanistic studies and drug testing.

Conclusions:

• No single model perfectly replicates the in vivo environment for studying arterial thrombosis.
• Continuous innovation in microfabrication and standardization enhances the physiological relevance and clinical translatability of these models.