Effects of walking in deep venous thrombosis: a new integrated solid and fluid mechanics model

Int J Numer Method Biomed Eng. 2017 May;33(5). doi: 10.1002/cnm.2819. Epub 2016 Sep 27.

Abstract

Deep venous thrombosis (DVT) is a common disease. Large thrombi in venous vessels cause bad blood circulation and pain; and when a blood clot detaches from a vein wall, it causes an embolism whose consequences range from mild to fatal. Walking is recommended to DVT patients as a therapeutical complement. In this study the mechanical effects of walking on a specific patient of DVT were simulated by means of an unprecedented integration of 3 elements: a real geometry, a biomechanical model of body tissues, and a computational fluid dynamics study. A set of computed tomography images of a patient's leg with a thrombus in the popliteal vein was employed to reconstruct a geometry model. Then a biomechanical model was used to compute the new deformed geometry of the vein as a function of the fiber stretch level of the semimembranosus muscle. Finally, a computational fluid dynamics study was performed to compute the blood flow and the wall shear stress (WSS) at the vein and thrombus walls. Calculations showed that either a lengthening or shortening of the semimembranosus muscle led to a decrease of WSS levels up to 10%. Notwithstanding, changes in blood viscosity properties or blood flow rate may easily have a greater impact in WSS.

Keywords: biomechanical model; computational fluid dynamics; deep venous thrombosis; international standard thrombotic treatment; wall shear stress.

MeSH terms

  • Hemodynamics
  • Humans
  • Models, Biological
  • Thrombosis
  • Veins
  • Venous Thrombosis / physiopathology*
  • Venous Thrombosis / therapy
  • Walking / physiology*