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PresentationsMathematical modeling of shear-induced platelet activation in patient-specific arteriovenous fistulas for hemodialysisNational Research Center for Hematology, Russia, 125167, Moscow, Novy Zykovsky proezd, 4. Moscow Institute of Physics and Technology, Russia, 141701, Moscow Region, Dolgoprudny, Institutskiy per., 9. City Clinical Hospital n.a. S.P. Botkin, Russia, 125284, Moscow, 2nd Botkinsky proezd, 5. Shear-induced platelet activation (SIPAct) is an important mechanism of thrombosis initiation under high blood flow. This mechanism relies on the interaction of platelets with the von Willebrand factor (VWF) capable of unfolding under high shear stress. High shear stress occurs in the arteriovenous fistula (AVF) commonly used for haemodialysis (replacement therapy for renal failure). The analysis of shear-induced platelet activation risks requires correct accounting of the hemodynamic features [1]. The aim of this work is to develop a mathematical approach for the estimation of shear-induced platelet activation risks in in patient-specific arteriovenous fistulas for hemodialysis. In the current study, methods of computational reconstruction of patient-specific vessel geometries, mathematical model of VWF-induced platelet activation under high shear [2] and computational fluid dynamics methods for numerical solving of the model equations have been combined. As a result, a novel patient-specific approach for the modelling of SIPAct has been developed. The capabilities of the approach were demonstrated via analysis of SIPact in two patient-specific AVF geometries reconstructed from medical images. The approach facilitates the determination of the SIPAct level dependence on both biomechanical (AVF flow rate) and biochemical factors (VWF multimer size). It was found that the dependence of the SIPAct level on the AVF flow rate can be approximated by a power law. The critical flow rate was a decreasing function of the VWF multimer size. Moreover, the critical AVF flow rate highly depended on patient-specific factors, e.g., the vessel geometry. This indicates that the approach may be adopted to elucidate patient-specific thrombosis risk factors in haemodialysis patients. The work was supported by grant No 19-11-00260 of Russian Science Foundation.
References 1. Salikhova T.Yu., Pushin D.M., Nesterenko I.V., Biryukova L.S., Guria G.Th. Patient specific approach to analysis of shear-induced platelet activation in haemodialysis arteriovenous fistula // PLOS ONE Vol. 17, 2022. Pp. 1-8. 2. Pushin D.M., Salikhova T.Y., Zlobina K.E., Guria G.Th. Platelet activation via dynamic conformational changes of von Willebrand factor under shear // PLOS ONE Vol. 15, 2020. Pp. 1‑17.
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