Effect of anticoagulant treatment in deep vein thrombosis: A patient-specific computational fluid dynamics study.
A methodology that might help physicians to establish a diagnostic and treatment tailored for each specific patient with a pathological thrombus is presented. A realistic model for the geometry of a popliteal vein with a thrombus just above the knee was reconstructed from in vivo computed tomography images acquired from one specific patient and then it was used to perform computational fluid dynamics (CFD) simulations. The wall shear stress (WSS) response to the administration of anticoagulant drugs and the influence of viscosity on the shape of the velocity distribution were investigated. Both a Newtonian and a non-Newtonian viscosity model were implemented for different blood flow rates in the range 3-7 cm(3)/s. The effect of anticoagulants on the blood was simulated by setting three different levels of viscosity in the Newtonian model (μ/μ∞=0.60, 0.80 and 1 with μ∞=3.45×10(-3) Pas). A reduction of μ by a given amount always led to a more modest reduction, typically by a factor of two, of the resulting WSS levels. Moreover, for a given flow rate the calculation with the non-Newtonian viscosity model yielded WSS levels between 20% and 40% larger than those obtained in the corresponding Newtonian fluid simulation. It was also found that blood moves slowly in the region between the thrombus and the vein wall, a fact that will favor the growth of the thrombotic mass. Both the mean WSS levels and the degree of sluggishness of the blood flow can be described by functions of the Reynolds number.
Departament d׳ Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalunya, Spain. Electronic address: gerard.fortuny@urv.cat.
Gerard
G
Fortuny
Departament d׳ Enginyeria Quimica, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalunya, Spain. Electronic address: joan.herrero@urv.cat.
Joan
J
Herrero
Departament d׳ Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalunya, Spain. Electronic address: dolors.puigjaner@urv.cat.
Dolors
D
Puigjaner
Departament d׳ Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalunya, Spain. Electronic address: carme.olive@urv.cat.
Carme
C
Olivé
Departament de Medicina i Cirurgia, Universitat Rovira i Virgili, Hospital Sant Joan, Reus, Catalunya, Spain. Electronic address: francesc.marimon@urv.cat.
Francesc
F
Marimon
Servei de Radiologia i Diagnòstic per la Imatge, Hospital Sant Joan, Reus, Catalunya, Spain. Electronic address: jrongarcia@yahoo.com.
Josep
J
Garcia-Bennett
Servei de Radiologia i Diagnòstic per la Imatge, Hospital Sant Joan, Reus, Catalunya, Spain. Electronic address: daniel.rodriguez@grupsagessa.com.
Daniel
D
Rodríguez
D000369:Aged, 80 and over; D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D013314:Stress, Mechanical; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000503:physiopathology*; D014783:Viscosity
D000925:Anticoagulants
Computational fluid dynamics; Deep vein thrombosis; Non-Newtonian fluid flow; Wall shear stress