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Thrombosis in Cerebral Aneurysms and the Computational Modeling Thereof: A Review

Ngoepe, MN; Frangi, AF; Byrne, JV; Ventikos, Y; (2018) Thrombosis in Cerebral Aneurysms and the Computational Modeling Thereof: A Review. Frontiers in Physiology , 9 (306) 10.3389/fphys.2018.00306. Green open access

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Abstract

Thrombosis is a condition closely related to cerebral aneurysms and controlled thrombosis is the main purpose of endovascular embolization treatment. The mechanisms governing thrombus initiation and evolution in cerebral aneurysms have not been fully elucidated and this presents challenges for interventional planning. Significant effort has been directed towards developing computational methods aimed at streamlining the interventional planning process for unruptured cerebral aneurysm treatment. Included in these methods are computational models of thrombus development following endovascular device placement. The main challenge with developing computational models for thrombosis in disease cases is that there exists a wide body of literature that addresses various aspects of the clotting process, but it may not be obvious what information is of direct consequence for what modeling purpose (e.g., for understanding the effect of endovascular therapies). The aim of this review is to present the information so it will be of benefit to the community attempting to model cerebral aneurysm thrombosis for interventional planning purposes, in a simplified yet appropriate manner. The paper begins by explaining current understanding of physiological coagulation and highlights the documented distinctions between the physiological process and cerebral aneurysm thrombosis. Clinical observations of thrombosis following endovascular device placement are then presented. This is followed by a section detailing the demands placed on computational models developed for interventional planning. Finally, existing computational models of thrombosis are presented. This last section begins with description and discussion of physiological computational clotting models, as they are of immense value in understanding how to construct a general computational model of clotting. This is then followed by a review of computational models of clotting in cerebral aneurysms, specifically. Even though some progress has been made towards computational predictions of thrombosis following device placement in cerebral aneurysms, many gaps still remain. Answering the key questions will require the combined efforts of the clinical, experimental and computational communities.

Type: Article
Title: Thrombosis in Cerebral Aneurysms and the Computational Modeling Thereof: A Review
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fphys.2018.00306
Publisher version: https://doi.org/10.3389/fphys.2018.00306
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Physiology, cerebral aneurysm, thrombosis, flow diverter, interventional planning, computational modeling, UNRUPTURED INTRACRANIAL ANEURYSMS, PIPELINE EMBOLIZATION DEVICE, OF-THE-LITERATURE, PLATELET ADHESIVE DYNAMICS, GUGLIELMI DETACHABLE COILS, HEALTH-CARE PROFESSIONALS, BLOOD-COAGULATION CASCADE, INTRA-CRANICAL ANEURYSMS, SINGLE-CENTER EXPERIENCE, TISSUE FACTOR ACTIVITY
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: http://discovery.ucl.ac.uk/id/eprint/10047616
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