TH Open (Apr 2021)

Thrombin–Fibrinogen In Vitro Flow Model of Thrombus Growth in Cerebral Aneurysms

  • Malebogo N. Ngoepe,
  • Etheresia Pretorius,
  • Ilunga J. Tshimanga,
  • Zahra Shaikh,
  • Yiannis Ventikos,
  • Wei Hua Ho

DOI
https://doi.org/10.1055/s-0041-1728790
Journal volume & issue
Vol. 05, no. 02
pp. e155 – e162

Abstract

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Cerebral aneurysms are balloon-like structures that develop on weakened areas of cerebral artery walls, with a significant risk of rupture. Thrombi formation is closely associated with cerebral aneurysms and has been observed both before and after intervention, leading to a wide variability of outcomes in patients with the condition. The attempt to manage the outcomes has led to the development of various computational models of cerebral aneurysm thrombosis. In the current study, we developed a simplified thrombin–fibrinogen flow system, based on commercially available purified human-derived plasma proteins, which enables thrombus growth and tracking in an idealized cerebral aneurysm geometry. A three-dimensional printed geometry of an idealized cerebral aneurysm and parent vessel configuration was developed. An unexpected outcome was that this phantom-based flow model allowed us to track clot growth over a period of time, by using optical imaging to record the progression of the growing clot into the flow field. Image processing techniques were subsequently used to extract important quantitative metrics from the imaging dataset, such as end point intracranial thrombus volume. The model clearly demonstrates that clot formation, in cerebral aneurysms, is a complex interplay between mechanics and biochemistry. This system is beneficial for verifying computational models of cerebral aneurysm thrombosis, particularly those focusing on initial angiographic occlusion outcomes, and will also assist manufacturers in optimizing interventional device designs.

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