Growth kinetics of platelet thrombi

A continuum model for platelet plug formation, growth and deformation

A numerical framework for modelling platelet plug dynamics is presented in this work. It consists of an extension of a biochemical and plug growth model with a solid mechanics model for the plug coupled with a fluid-structure interaction model for the blood flow-plug system. The platelet plug is treated as a neo-Hookean elastic solid, of which the implementation is based on an updated Lagrangian approach. The framework is applied to different haemodynamic configurations coupled with different shear moduli of the plug. Results about plug growth, shape and size, as well as the stress distribution, are shown. Based on the simulations performed, we conclude that the deformability of the platelet plug is essential for its growth.

Suffocation of Nerve Fibers by Living Nanovesicles: A Model Simulation−Part II

Nanobacteria may cause peripheral neuropathy by adhesion to the perineurium. This hypothesis receives support from five independent observations: (1) identification of perineurial apatite in diabetic patients with peripheral neuropathy, (2) massive presence of nanobacteria in a diabetic patient, (3) beneficial effect of lasers on peripheral neuropathy, (4) model simulation indicating that perineurial deposition and attachment of nanobacteria is encouraged by both their size and chemical nature, and (5) transient inhibition of neural function by apatite. Initial deposition of (stressed) nanobacteria is promoted by a slime thought to consist of proteins, calcium, and phosphate, and is most likely followed by an immobilization phase, mediated by a bioadhesive capacity of the apatite. Proteomics may hold the key to control both attachment processes.

Quantitative evaluation of thrombosis by electrochemical methodology

Electrochemical reactions between blood and metal electrodes have been studied since 1928. Little is known about the actual current density induced during the reaction. In this study, an in situ continuous monitoring method was developed to detect the progress of thrombosis on an oxidized 316L stainless steel coil was deployed inside the artery. Three stages of current density were observed on a 316L wire passivated with polycrystalline oxide film. In contrast, no significant current density was detected for a wire passivated with amorphous oxide film. Results showed that this in situ electrochemical monitoring method is sensitive to the passivated film on the stainless steel coil and could provide efficient and reliable information on the control of thrombosis on cardiovascular devices.

Fluid mechanics of vascular systems, diseases, and thrombosis

The cardiovascular system is an internal flow loop with multiple branches circulating a complex liquid. The hallmarks of blood flow in arteries are pulsatility and branches, which cause wall stresses to be cyclical and nonuniform. Normal arterial flow is laminar, with secondary flows generated at curves and branches. Arteries can adapt to and modify hemodynamic conditions, and unusual hemodynamic conditions may cause an abnormal biological response. Velocity profile skewing can create pockets in which the wall shear stress is low and oscillates in direction. Atherosclerosis tends to localize to these sites and creates a narrowing of the artery lumen--a stenosis. Plaque rupture or endothelial injury can stimulate thrombosis, which can block blood flow to heart or brain tissues, causing a heart attack or stroke. This small lumen and elevated shear rate in a stenosis create conditions that accelerate platelet accumulation and occlusion. The relationship between thrombosis and fluid mechanics is complex, especially in the post-stenotic flow field. New convection models have been developed to predict clinical from platelet thrombosis in diseased arteries. Future hemodynamic studies should address the complex mechanics of flow-induced, large-scale wall motion and convection of semisolid particles and cells in flowing blood.

A model for thromboembolization on biomaterials

A model was developed to describe the kinetics of protein and platelet deposition and embolization on biomaterials. The model assumes that proteins can be adequately represented by fibrinogen, albumin, and Factor XII, that protein adsorption is Langmuir-type, that surfaces are homogeneous, and that all adsorption and deposition steps are first order. Eleven model parameters were determined from literature experimental data from ex vivo experiments utilizing canine and baboon blood on Silastic, one parameter came from adsorption of Factor XII on glass, and three parameters were obtained by minimizing differences between experimental and predicted fibrinogen adsorption, and platelet deposition and embolization behavior. The model well predicted observed behavior for fibrinogen adsorption, platelet deposition, and platelet embolization on Silastic, and platelet embolization from both polyacrylamide and HEMA-MAAC.

A mathematical model of the kinetics of platelets and plasma hemostasis system interaction

A mathematical model of the kinetics of platelet-activated blood coagulation is presented. Non-linear positive feedbacks due to the action of co-factor Va and VIIIa, thrombin-induced platelet activation, the secretion of factor V by platelets are taken into account. The intrinsic pathway is shown not to be activated in the absence of platelets for small stimulation intensities. The activation occurs if initial platelet activation by inductors other than thrombin exceeds a threshold value.

A model of deposition and embolization of proteins and platelets on biomaterial surfaces

A theoretical model for the deposition and detachment of protein and platelets on biomaterial surfaces is presented here. This work is an extension of the model previously reported. Two mechanisms of protein and platelet removal are assumed: A characteristic time elapses before adsorbed protein detaches from the surface, carrying away platelets and protein which have deposited on top of it; and thrombi that attain a critical size are subject to hydrodynamic forces which embolize them from the surface. A theoretical distribution of thrombus sizes is assumed. Analysis of the effects of varying model parameters on predicted protein and platelet deposition reveals that the addition of the embolization process does not change the overall structure of the deposition profiles, but does significantly affect the finer details.

Role of red cells in preventing the growth of platelet aggregation

Using high-resolution real-time two-dimensional ultrasound, we have investigated the role of red cells in the growth of already established platelet aggregates under controlled flow conditions. Platelet rich plasma (PRP) was circulated in vitro in horizontally and vertically arranged tubing at mean shear rate ranging from 60 to 0 sec-1, and adenosine diphosphate (ADP) was used to induce platelet aggregation. ADP-induced platelet aggregates grew in size and tended to sediment as shear rate decreased, in particular, below 10 sec-1. At 0 sec-1 (stasis), large clusters of platelet aggregates formed. The addition of washed red cells to produce a hematocrit of only 2% significantly interfered with the growth and sedimentation of platelet aggregates as shear rate was reduced. Formaldehyde-hardened erythrocytes had a similar effect in preventing the growth of platelet aggregates, suggesting that mechanical collision of red cells with platelet aggregates may be the cause of growth inhibition. Therefore, the thrombotic process may be enhanced in red cell poor zones in circulation resulting from flow disturbances associated with vascular stenosis or within artificial organs and extracorporeal systems. The present study also suggested that red cell free PRP should be carefully administered therapeutically.