Thrombus Initiation With Subsequent Growth Measured for Physiological Shear and High Pathological Shear

Arterial thrombosis is often found near an atheroma in atherosclerotic disease, which can lead to acute myocardial infarction, i.e. a heart attack. Thrombus typically grows in regions of exposed subendothelium, which can exist when the plaque cap of the atheroma ruptures or erodes. The subendothelium creates an adherent surface to platelets and other thrombus constituents. Furthermore, an atheroma alters the normal physiological hemodynamics, which has been reported to correspond to local thrombus growth, despite equally adherent surfaces in undisturbed flow regions [1,2]. However, there has been some disagreement about which hemodynamics, specifically shear, may play the most influential role of localizing thrombus. Low shear and high shear have both resulted in thrombus growth [1,2]. Shear in the region of an atheroma can get over 100,000 s−1 [3].