Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

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

DOI QR Code

The Effect of Urokinase Infusion Regimens on Thrombolysis - a Numerical Study

  • Jeong, Woo-Won (Division of Mechanical Engineering, Myongji University) ;
  • Jang, An-Sik (Division of Mechanical Engineering, Myongji University) ;
  • Rhee, Kye-Han (Division of Mechanical Engineering, Myongji University)
  • Published : 2006.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Numerical analysis was performed on the enzyme transport and the flow fields in order to predict the effectiveness of urokinase injection regimens in clot dissolution. The species and momentum transport equations were numerically solved for the case of uniform perfusion of enzyme into a fibrin clot for an arterial thrombus and a deep vein thrombus models. In order to predict the thrombus lysis efficiency of continuous and forced intermittent injections, enzyme perfusion and clot lysis were simulated for the different injection velocities. Intermittent injection showed faster clot lysis compared to continuous perfusion, and lysis efficiency was increased as injection velocity increased.

Keywords

References

  1. A. Ward, S. Andaz, and S. Bygrave, 'Thrombolysis with tissue type plasmonogen activator,' J. Vasc. Surg., vol. 19, pp.503-508, 1994 https://doi.org/10.1016/S0741-5214(94)70078-8
  2. N. Khilnami, M. Lee, and P. Winchester, 'In vitro model to evaluate the relative efficacy of catheter directed thrombolytic strategies,' Acad. Radiol., vol. 9, pp.121-128, 1996
  3. J.J. Floelich, C. Freymann, M. Hoppe, T. Tiel, H. J. Wagner, K.H. Barth, and KJ. Klose, 'Local intraarterial thrombolysis: in vitro comparison between automatic and manual pulse spry injection,' Cardiovasc Intervent Radiol., vol. 19, pp.423-427, 1996 https://doi.org/10.1007/BF02577631
  4. C.W Francis., 'Ultrasound-enhanced thrombolysis,' Echocardiography, vol. 18, pp.239-246, 2001 https://doi.org/10.1046/j.1540-8175.2001.00239.x
  5. A. Blinc, G. Planinsic, D. Keber, O. Jarh, G. Lahajnar, A. Zidansek, and F. Demsar, 'Dependence of blood clot lysis on the mode of transport of urokinase into a clot: a magnetic resonance imaging studying vitro,' Thromb Haemostas, vol.65, pp.549-552, 1991 https://doi.org/10.1055/s-0038-1648188
  6. A. Blinc, D. Keber, G. Lahajnar, M. Stegnar, A. Zidansek, and F. Demsar, 'Lysing patterns of retracted blood clots with diffusion or bulk flow transport of urokinase into the clots: a magnetic resonance study in vitro,' Thromb Haemostas, vol.68, pp.667-671, 1992
  7. J. Wu, S. Khalid, S.L. Diamond, 'Transport phenomena and clot dissolving therapy: An experimental investigation of diffusioncontrolled and permeation-enhanced fibrinolysis,' Thromb Haemostas, vol. 72, pp.105-112, 1994
  8. S.L. Diamond and S. Anand, 'Inner clot diffusion and permeation during fibrinolysis,' Biophys J., vol 65, pp.2622-2643, 1993 https://doi.org/10.1016/S0006-3495(93)81314-6
  9. S. Roy, F. Laerum, and F. Brosstad, 'Quantitative evaluation of selective thrombolysis techniques: Influence of catheter characteristics and delivery parameters,' Cathe Cadiovas Diagnos, vol. 43, pp.111-119, 1998 https://doi.org/10.1002/(SICI)1097-0304(199801)43:1<111::AID-CCD32>3.0.CO;2-Q
  10. K. Kandarpa, P.S. Chopra, and J.E. Aruny, 'Intraarterial thrombolysis of lower extremity occlusions: Prospective, randomized comparison of forced periodic infusion and conventional slow continuous infusion,' Radiology, vol. 188, pp.861-867, 1993 https://doi.org/10.1148/radiology.188.3.8351363
  11. A. Blinc, S.D. Kenndy, R.G. Bryant, V.J. Marder, and C.W. Francis, 'Flow through clots determines the rate and pattern of fibrnolysis,' Thromb Haemostas, vol. 71, pp.230-235, 1994
  12. W.W. Jeong and K. Rhee, 'Numerical analysis of forced injection of enzyme during thrombolysis,' Comp. Eng. Med., accepted for publication
  13. M. E. Carr and C.L. Hardin, 'Fibrin has larger pores when formed in presence of erythrocytes,' Am. J. Physiol., vol. 253, pp.H1069-1073, 1987
  14. S.L. Diamond, 'Engineering design of optimal strategies for blood clot dissolution,' Ann. Rev. Biomed. Eng., vol.1 , pp.427461, 1999 https://doi.org/10.1146/annurev.bioeng.1.1.427
  15. M.J. Underwood, R. More, A.H. Gershlick, and D.P. de Bono, 'Quantifying the effects of locally delivered anticoagulant drugs: Modification of an in vivo model of venous thrombosis,' J. Vasc. Res., vol. 30, pp.323-326, 1993 https://doi.org/10.1159/000159013
  16. C.L. Zollikofer, E. Schoch, M. Pfyffer, and G. Stuckman, 'Accelerated thrombolysis with a microporous angioplasty balloon,' Cardiovasc. Intervent. Radiol., vol. 18, p. S66, 1995
  17. M.C. Bruner, T.A.S. Matalon, S.K. Patel SK, V. McDonald, and S.C. Jensik, 'Ultralipid urokinase in hemodialysis access occlusion,' J. Vasc. Intervent. Radiol., vol. 2, pp.503-506, 1991 https://doi.org/10.1016/S1051-0443(91)72232-X
  18. M. Sabovic and D. Keber, 'Factors influencing the lysis of ex vivo human thrombi. Fibrolysis,' vol.19, pp.103-109, 1996
  19. B. Blomback, K. Carlsson, B. Hessel, and R. Procyk, 'Fibrin in human plasma gel: gel architectures governed by rate and nature of fibrinogen activation,' Thromb. Res., vol. 75, pp. 521-538, 1994 https://doi.org/10.1016/0049-3848(94)90227-5