Abstract
Multiple interacting mechanisms control the formation and dissolution of clots to maintain blood in a state of delicate balance. In addition to a myriad of biochemical reactions, rheological factors also play a crucial role in modulating the response of blood to external stimuli. To date, a comprehensive model for clot formation and dissolution, that takes into account the biochemical, medical and rheological factors, has not been put into place, the existing models emphasizing either one or the other of the factors. In this paper, after discussing the various biochemical, physiologic and rheological factors at some length, we develop a model for clot formation and dissolution that incorporates many of the relevant crucial factors that have a bearing on the problem. The model, though just a first step towards understanding a complex phenomenon, goes further than previous models in integrating the biochemical, physiologic and rheological factors that come into play.
Acknowledgements
We wish to thank the National Energy Technology Laboratory of the US Department of Energy for its support of this work through the University Partnership Program.
Notes
¶It is somewhat simplistic to envisage the formation of clot as the end product of a sequence of processes. Many of the processes, like platelet activation, aggregation, coagulation and fibrinolysis, are interlinked, and interact much earlier than was previously thought; for instance, Factor VIII (f-VIII) circulates in the plasma bound to von Willebrand Factor (vWF), and requires cleavage by thrombin to release f-VIII (required for thrombin production) and vWF (required for platelet aggregation).
§Although there is mention of a model in Nesheim and Fredenburgh (Citation1988), the details are absent.