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Computational framework for modeling blood clotting in extravascular injuries, A
Montgomery, David Robert
Montgomery, David Robert
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2023
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Abstract
Hemostasis is the process by which a blood clot forms to prevent bleeding at the site of an injury. The formation time, size, and structure of a blood clot depends on the local hemodynamics and the nature of the injury. Previous computational models have focused primarily on intravascular clotting, where there is no blood loss and clotting is limited to the interior of a vessel. Models of extravascular clotting, where blood leaks from a vessel into the extravascular space, are still early in development. In this thesis we present a mathematical and computational framework for simulating clotting in both intravascular and extravascular settings. The framework we developed includes an open-source software package called clotFoam, that simulates blood clotting using a continuum model of blood coagulation and platelet aggregation within a dynamic fluid environment. The governing equations include advection, diffusion, reaction, and Navier-Stokes-Brinkman equations, and are solved using a finite volume approach built upon the open-source libraries of OpenFOAM. Within this new framework, we investigate the influence of transmural pressure and injury size on clot structure and occlusion times in extravascular injuries. We found that increasing the transmural pressure prolonged the occlusion times and increased the density of the blood clots that formed in the extravascular space. However, occlusion times were longer than expected for the high-shear environments that we studied. This motivated the development of a new mathematical model that incorporated shear-dependence into the platelet aggregation. Simulations with this model resulted in shorter, more relevant occlusion times when shear was increased, highlighting the importance of including shear-dependence into the model. Our framework provides the foundation on which one can build more complex models and perform reliable simulations in almost any computational domain.
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