Comparing biomechanical platelet activation in the carotid artery by computational and experimental modeling

Disturbed blood flow in aneurysmal or stenotic arteries generates pathological shear stress, a key driver of platelet activation, which, in turn, is a mechanism central to stroke and myocardial infarction. Here, we integrated patient-specific computational fluid dynamics (CFD) modeling with ex vivo biomechanical assays to evaluate shear-induced platelet activation in individuals with vascular disease. CFD models derived from computed tomography angiography of patients with carotid artery stenosis due to atherosclerosis or fibromuscular dysplasia predicted elevated platelet activation relative to healthy controls. These in silico predictions were validated using a custom-designed platelet shear disc apparatus that quantified platelet activation under controlled shear environments. Concordance between CFD-derived estimates and experimental measurements underscores the utility of CFD as a noninvasive tool to assess the contribution of platelets to thrombotic risk in patients. Our findings support the translational potential of combining CFD modeling with biomechanical validation for risk stratification and to inform therapeutic strategies in patients with stenotic vascular disorders.