Lagrangian tracking of platelet residence time and shear history to enhance understanding of the hemodynamics of endovascular stenting in cerebral aneurysms

ORAL

Abstract

Flow-diverting stents (FDS) promote the formation of a stable thrombus within the aneurysmal sac, isolating its wall from mechanical stresses and preventing rupture. Platelet activation, a necessary mechanism for thrombus formation, is known to respond to biomechanical stimuli, particularly to the platelets’ shear stress exposure and residence time in the aneurysmal sac. Currently, there is no accurate prediction of FDS outcomes. Eulerian computational fluid dynamic studies of aneurysmal flow have searched for predictors of endovascular treatment outcome; however, the hemodynamics of thrombus formation cannot be fully understood without considering the platelets’ Lagrangian microenvironment and their mechanics-triggered activation. Lagrangian analysis of the fluid mechanics in the aneurysmal vasculature provides novel metrics by tracking the platelets’ residence time (RT) and shear history (SH) and combining them into a treatment success potential score. The comparison of such parameters for patient-specific cases, pre- and post-treatment, will be presented. The methodology proposed for developing platelet-based Lagrangian tracking studies into accurate predictors of endovascular stenting outcome will be described in detail.

–

Presenters

  • Laurel Morgan Miller Marsh

    Department of Mechanical Engineering, University of Washington, Seattle, WA, USA

Authors

  • Laurel Morgan Miller Marsh

    Department of Mechanical Engineering, University of Washington, Seattle, WA, USA

  • Michael C Barbour

    Department of Mechanical Engineering, University of Washington, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA

  • Fanette Chassagne

    Department of Mechanical Engineering, University of Washington, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA, University of Washington, Department of Mechanical Engineering

  • Venkat Keshav Chivukula

    Department of Mechanical Engineering, University of Washington, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA, University of Washington, Department of Mechanical Engineering, University of Washington

  • Cory M. Kelly

    Department of Neurological Surgery, University of Washington, Seattle, WA, USA

  • Samuel H. Levy

    Department of Neurological Surgery, University of Washington, Seattle, WA, USA

  • Michael R Levitt

    Department of Neurological Surgery, University of Washington, Seattle, WA, USA, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA, Department of Neurological Surgery, University of Washington, Seattle, WA, USA

  • Louis J. Kim

    Department of Neurological Surgery, University of Washington, Department of Neurological Surgery, University of Washington, Seattle, WA, USA, Department of Neurological Surgery, University of Washington, Seattle, WA, USA, Department of Radiology, University of Washington, Seattle, WA, USA

  • Alberto Osuna Aliseda

    University of Washington, Department of Mechanical Engineering, University of Washington, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA, Department of Neurological Surgery, University of Washington, Seattle, WA, USA, Mechanical Engineering Department, University of Washington, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA, Mechanical Engineering, University of Washington, Seattle, USA