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Computational simulations of thrombolysis in acute stroke: Effect of clot size and location on recanalisation
- Source :
- Medical Engineering & Physics. 73:9-17
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Acute ischaemic stroke can be treated by intravenous thrombolysis whereby tissue plasminogen activator (tPA) is infused to dissolve clots that block blood supply to the brain. In this study, we aim to examine the influence of clot location and size on lysis pattern and recanalisation by using a recently developed computational modelling framework for thrombolysis under physiological flow conditions. An image-based patient-specific model is reconstructed which consists of the internal carotid bifurcation with the A1 segment of anterior cerebral arteries and M1 segment of middle cerebral arteries, and the M1 bifurcation containing the M2 segments. By varying the clot size and location, 7 scenarios are simulated mimicking thrombolysis of M1 and M2 occlusions. Our results show that initial breakthrough always occurs along the inner curvature of the occluded cerebral artery, due to prolonged tPA residence time in the recirculation zone. For a given occlusion site, lysis completion time appears to increase almost quadratically with the initial clot volume; whereas for a given clot volume, the simulated M2 occlusions take up to 30% longer for complete lysis compared to the corresponding M1 occlusions.
- Subjects :
- medicine.medical_specialty
Tissue plasminogen activator (tPA)
Time Factors
medicine.medical_treatment
0206 medical engineering
Cerebral arteries
Biomedical Engineering
Biophysics
Blood clot
02 engineering and technology
Tissue plasminogen activator
09 Engineering
03 medical and health sciences
0302 clinical medicine
Internal medicine
Ischaemic stroke
Occlusion
Pressure
medicine
Carotid bifurcation
Computer Simulation
Thrombolytic Therapy
Blood Coagulation
11 Medical and Health Sciences
Acute stroke
02 Physical Sciences
business.industry
Computational model
Hemodynamics
Drug transport
Thrombolysis
020601 biomedical engineering
Stroke
Tissue Plasminogen Activator
Physiological flow
Cardiology
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 13504533
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- Medical Engineering & Physics
- Accession number :
- edsair.doi.dedup.....0277ea9bf853d639a798bbc1dbd6de7e