Summary For the estimated 700,000 acute ischemic strokes (AIS) that occur each year in the United States, new stent retriever devices have shown an increase in recanalization of occluded cerebral arteries. However, over 15% of thromboemboli are still unable to be cleared and another 17% of patients die within 90 days despite successful recanalization. To date, there is little understanding of the upstream thrombosis and embolization processes that lead to AIS and why some thromboemboli are successfully removed and others are not. To better understand the entire progression of AIS, we will develop computational models of the upstream thrombosis, thrombus embolization, lodging and adhesion in the cerebral vasculature, and removal via applied forces from a thrombectomy device. These models will be validated with ex vivo mock circulatory flow loops that enable real-time tracking of thrombus growth and embolization and for AIS occlusion to be simulated in physiologically accurate scenarios. Furthermore, patient-specific anatomy and blood chemistry will be used. The results of these studies will provide insight to AIS occlusion but provide an opportunity to improve overall patient outcomes.

Public Health Narrative Acute ischemic stroke is a significant clinical problem in the United States where nearly 15% of the blocked cerebral arteries cannot be cleared. Understanding how clots detach, lodge and cannot be removed are essential to developing new methodologies that will successfully remove these specific clots.