Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
권호 표지

A Numerical Study on the Effects of Drug Ejection Velocity on Endovascular Thrombolysis

  • Jeong Woo Won (Division of Mechanical Engineering, Myongji University) ;
  • Rhee Kyehan (Division of Mechanical Engineering, Myongji University)
  • Published : 2005.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Direct injection of a fibrinolytic agent to the intraarterial thrombosis may increase the effectiveness of thrombolysis by enhancing the permeation of thrombolytic agents into the blood clot. Permeation of fibrinolytic agents into a clot is influenced by the surface pressure, which is determined by the injection velocity of fibrinolytic agents. In order to calculate the pressure distribution on the clot surface for different jet velocities (1, 3, 5 m/sec) and nozzle arrangements (1, 9, 17 nozzles), computational fluid dynamic methods were used. Thrombolysis of a clot was mathematically modeled based on the pressure and lysis front velocity relationship. Direct injection of a thrombolytic agent increased the speed of thrombolysis significantly and the effectiveness was increased as the ejecting velocity increased. The nine nozzles model showed about $20\%$ increase of the lysed volume, and the one and seventeen nozzles models did not show significant differences. The wall shear stress decreased as the number of nozzles increased, and the wall shear stress in most vessel wall was lower than 25 Pa. The results implied that thrombolysis could be accelerated by direct injection of a drug with the moderate velocity without damaging the blood vessel wall.

Keywords

References

  1. C. M. Smith, A. E. Yellin, F. A. Weaver, K. M. Li, and A. E. Siegel, 'Thrombolytic therapy for arterial occlusion; A mixed blessing', The American Surgeon, Vol. 60, pp.371-375, 1994
  2. J. C. Chaloupka, S. Mangla, and D. C. Huddle, 'Use of mechanical thrombolysis via micro balloon percutaneous trans luminal angioplasty for the treatment of acute dural sinus thrombosis', Neurosurgery, Vol. 45, pp.650-657, 1999 https://doi.org/10.1097/00006123-199909000-00045
  3. T. M. Vesely, 'Mechanical thrombectomy devices to treat thrombosed hemodialysis grafts', Techniques in Vase. & Interv. Radiol., Vol 6, pp.35-41, 2003 https://doi.org/10.1053/tvir.2003.36438
  4. C. F. Dowd, A. M. Malek, C. C. Phatouros, and J. C. Hemphill, 'Application of a rheolytic thrombectomy device In the treatment of dural sinus thrombosis: a new technique', A.J.N.R., Vol. 20, pp. 568-570, 1999
  5. M. Kobayashi, S. Sawada, N. Tanigawa, T. Senda, and Y. Okuda, 'Water jet angioplasty-an experimental study', Acta Radiologica, Vol.36, pp.453-456, 1995 https://doi.org/10.1177/028418519503600423
  6. R. K. Greenberg, K. Ouriel, S. Srivastava, C. Shortell, K. Ivancev, D. Waldman, K. Illig, and R. Green, 'Mechanical versus chemical thrombolysis: An in vitro differentiation of thrombolytic mechanism', J. Vase. Interv. Radiol., Vol. 11, pp.199-205, 2000 https://doi.org/10.1016/S1051-0443(07)61465-1
  7. S. L. Diamond, 'Engineering design of optimal strategies for blood clot dissolution', Ann. Rev, Biomed. Eng., Vol. 1, pp.427-461, 1999 https://doi.org/10.1146/annurev.bioeng.1.1.427
  8. J. P. Collet, C. Lesty, G. Montalescot, and J. W. Weisel, 'Dynamic changes of fibrin architecture during fibrin formation and intrinsic fibrinolysis of fibrin-rich clots', J. Biol. Chem., Vol. 278, pp. 21331-21335, 2003 https://doi.org/10.1074/jbc.M212734200
  9. M. Sabovic, and D. Keber, 'Factors influencing the lysis of ex vivo human thrombi', Fibrinolysis, Vol. 10, pp. 103-109, 1996
  10. A. Bline, D. Keber, G. Lahajnar, M. Stegnar, A. Zidansek, and F. Demsar, 'Lysis patterns of retracted blood clots with diffusion or bulk flow transport of urokinase into the clot: a magnetic resonance imaging study in vitro', Thromb. Haemostas., Vol. 68, pp.667-671, 1992
  11. J. Wu, K. Siddiqui, and S. L. Diamond, 'Transport phenomena and clot dissolving therapy: An experimental investigation of diffusion controlled and permeation enhanced fibrinolysis', Thromb. and Hemostas., Vol. 72, pp. 105-112, 1994
  12. A. Bline, S. D. Kennedy, R. G. Bryant, V. J. Marder, and C. W. Francis, 'Flow through clots determines the rate and pattern of fibrinolysis', Thromb. and Hemostas., Vol.71, pp. 230-235, 1994
  13. G. Tratar, A. Blinc, M. Strukelj, U. Mikac, and I. Sersa, 'Turbulent axially directed flow ad plasma promotes thrombolysis of non-occlusive whole blood clots in vitro', Vol 91,pp. 487-496, 2004
  14. D. L. Fry, 'Acute vascular endothelrial changes associated with increased blood velocity gradients', Cir. Res., Vol. 22, pp. 165-182, 1968 https://doi.org/10.1161/01.RES.22.2.165