Stenosis and Thrombosis

Abstract

Vascular stenosis is defined as a narrowing or constriction to the body or opening of a vessel conduit. Stenosis and thrombus formations are the result of vascular injury and inflammation due to vascular cell dysfunction, resulting in any of the following pathological or healing injury responses: an initial coagulation/thrombus (blood clot) on the vascular inner wall to promote healing or further injury and inflammation; vascular smooth muscle cell proliferation and migration into the blood vessel lumen promoting stenosis following an initial disruption to the endothelium; atherosclerosis in which both early thrombus and smooth muscle cell proliferation and migration participate; and atherothrombosis that interacts with a mature atherosclerotic plaque to form a blood clot on the surface of the plaque resulting in further stenosis or possible emboli. Changes in vascular function are governed by the dynamic mechanical environment consisting of shear stress, wall stresses, and pressure imposed on the cells within the vascular wall as a result of blood flow. Endothelial cells in the intima and the smooth muscle cells within the vessel media are stimulated with these mechanical stresses that alter their behavior. Atherosclerosis and other causes of stenosis develop at localized regions within the vasculature that correlate to localized mechanical conditions. Disease typically occurs at arterial sites where endothelial cells would be exposed to low and oscillatory shear stress. Localized variations in the inner to outer wall stresses also appear to be related to disease‐formation. This chapter reviews studies integrating biology with vascular mechanical events that explain the current theories on stenosis and thrombosis.

Is Target Vessel and Device Diameter Important for Results in Peripheral Interventions for Femoropopliteal Artery Disease?

“…Arteryel çapın ve kullanılan endovasküler cihazların küçük olması, restenoz ve trombüs riskini arttırır. Bu durum, akışkan dinamiğinin etkilediği küçük kesit alanında akımın türbülansa meyilli olması ve hızlanmasının endotelyal hasarı tetikleyebileceği ve protrombotik bir ortam oluşturabileceği temeline dayanmaktadır (8). PAH'da, KAH'ye benzer şekilde, küçük çaplı arterler ve onlara uygulanan tedaviler zorluklar yaratır (9).…”

Comparative evaluation of straight and curved extension dialysis catheters for continuous renal replacement therapy in dogs with acute kidney injury

“…These factors include restenosis due to surgical manipulation, vessel shear strain, pressure, and vascular remodeling in response to injury. 12 Vascular endothelial cells can sense and respond to changes in the forces acting on them especially oscillatory pressure changes by modulating expression at the cellular level. 12 Moreover, this response may be aggravated in the presence of high resistance offered by the dual-lumen catheters causing oscillatory pressure changes leading to perpetuating endothelial pathological response.…”

“…12 Vascular endothelial cells can sense and respond to changes in the forces acting on them especially oscillatory pressure changes by modulating expression at the cellular level. 12 Moreover, this response may be aggravated in the presence of high resistance offered by the dual-lumen catheters causing oscillatory pressure changes leading to perpetuating endothelial pathological response. Therefore, a vicious cycle sets in, which corrodes the adequacy of CRRT 5 .…”

Hall and ion slip effects on hybrid nanoparticles (Au-GO/blood) flow through a catheterized stenosed artery with thrombosis

“…In subclavian dialysis, edema has occurred on the hand of the patient, leading to stenosis or thrombosis, which can be removed by giving an anticoagulant with heparin. Welsh et al 3 studied that the endothelial cells exposed to low shear stress are responsible for these diseases. Elnaqeeb et al 4 explored the effect of Cu nanoparticles on the catheterized stenotic artery with a varying shape parameter for the stenosis.…”