Introducing the pro-coagulant contact system in the numerical assessment of device-related thrombosis

Abstract : Thrombosis is a major concern in blood-coated medical devices. Contact activation, which is the initial part of the coagulation cascade in device-related thrombosis, is not considered in current thrombus formation models. In the present study, pro-coagulant reactions including the contact activation system are coupled with a fluid solver in order to evaluate the potential of the contact system to initiate thrombin production. The biochemical/fluid model is applied to a backward facing step configuration, a flow configuration that frequently appears in medical devices. In contrast to the in vivo thrombosis models in which a specific thrombotic zone (injury region) is set a priori by the user to initiate the coagulation reaction, a reactive surface boundary condition is applied to the whole device wall. Simulation results show large thrombin concentration in regions related to recirculation zones without the need of an a priori knowledge of the thrombus location. The numerical results align well with the regions prone to thrombosis observed in experimental results reported in the literature. This approach could complement throm-bus formation models that take into account platelet activity and thrombus growth to optimize a wide range of medical devices.
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Rodrigo Méndez Rojano, Simon Mendez, Franck Nicoud. Introducing the pro-coagulant contact system in the numerical assessment of device-related thrombosis. Biomechanics and Modeling in Mechanobiology, Springer Verlag, 2018, 17 (3), pp.815-826. ⟨10.1007/s10237-017-0994-3⟩. ⟨hal-01826601⟩

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