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Petkantchin R, Rousseau A, Eker O, Zouaoui Boudjeltia K, Raynaud F, Chopard B. A simplified mesoscale 3D model for characterizing fibrinolysis under flow conditions. Sci Rep 2023; 13:13681. [PMID: 37608073 PMCID: PMC10444897 DOI: 10.1038/s41598-023-40973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/19/2023] [Indexed: 08/24/2023] Open
Abstract
One of the routine clinical treatments to eliminate ischemic stroke thrombi is injecting a biochemical product into the patient's bloodstream, which breaks down the thrombi's fibrin fibers: intravenous or intravascular thrombolysis. However, this procedure is not without risk for the patient; the worst circumstances can cause a brain hemorrhage or embolism that can be fatal. Improvement in patient management drastically reduced these risks, and patients who benefited from thrombolysis soon after the onset of the stroke have a significantly better 3-month prognosis, but treatment success is highly variable. The causes of this variability remain unclear, and it is likely that some fundamental aspects still require thorough investigations. For that reason, we conducted in vitro flow-driven fibrinolysis experiments to study pure fibrin thrombi breakdown in controlled conditions and observed that the lysis front evolved non-linearly in time. To understand these results, we developed an analytical 1D lysis model in which the thrombus is considered a porous medium. The lytic cascade is reduced to a second-order reaction involving fibrin and a surrogate pro-fibrinolytic agent. The model was able to reproduce the observed lysis evolution under the assumptions of constant fluid velocity and lysis occurring only at the front. For adding complexity, such as clot heterogeneity or complex flow conditions, we propose a 3-dimensional mesoscopic numerical model of blood flow and fibrinolysis, which validates the analytical model's results. Such a numerical model could help us better understand the spatial evolution of the thrombi breakdown, extract the most relevant physiological parameters to lysis efficiency, and possibly explain the failure of the clinical treatment. These findings suggest that even though real-world fibrinolysis is a complex biological process, a simplified model can recover the main features of lysis evolution.
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Affiliation(s)
- Remy Petkantchin
- Scientific and Parallel Computing Group, Computer Science Department, University of Geneva, Geneva, Switzerland.
- Complex System Modeling Group, Computer Science Department, University of Geneva, Geneva, Switzerland.
| | - Alexandre Rousseau
- Laboratory of Experimental Medicine (ULB222), Faculty of Medicine, Université libre de Bruxelles, CHU de Charleroi, Charleroi, Belgium
| | - Omer Eker
- Department of Neuroradiology, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- CREATIS Laboratory, UMR 5220, U1206, Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, Lyon, France
| | - Karim Zouaoui Boudjeltia
- Laboratory of Experimental Medicine (ULB222), Faculty of Medicine, Université libre de Bruxelles, CHU de Charleroi, Charleroi, Belgium
| | - Franck Raynaud
- Scientific and Parallel Computing Group, Computer Science Department, University of Geneva, Geneva, Switzerland
- Complex System Modeling Group, Computer Science Department, University of Geneva, Geneva, Switzerland
| | - Bastien Chopard
- Scientific and Parallel Computing Group, Computer Science Department, University of Geneva, Geneva, Switzerland
- Complex System Modeling Group, Computer Science Department, University of Geneva, Geneva, Switzerland
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Migliavacca F, Luraghi G, Akyildiz AC, Gijsen FJH. Thrombus mechanics: How can we contribute to improve diagnostics and treatment? J Biomech 2021; 132:110935. [PMID: 35026650 DOI: 10.1016/j.jbiomech.2021.110935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Francesco Migliavacca
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy.
| | - Giulia Luraghi
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Ali C Akyildiz
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands; Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Frank J H Gijsen
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands; Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
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