Formation and destruction of primary thrombi under the influence of blood flow and von Willebrand factor analyzed by a discrete element method

Thrombogenesis and thrombolysis processes were simulated using a computational mechanics method called the discrete element method (DEM) to model the mechanical interactions between blood flow, platelets, the vessel wall, and von Willebrand factor (vWf). The inclusion of vWf and a complex blood flow field in the DEM are new developments used in this study. A primary thrombus did not form in the simulations if only the axial fluid force was considered, even when vWf was activated to simulate an endothelial injury. When the radial fluid force was considered to include the exclusion effect of erythrocytes, the modeled platelets formed primary thrombi at lesions where vWf was present. This suggests that activation of vWf is not sufficient to promote the formation of primary thrombi; a complex flow field that facilitates the transport of platelets towards the wall is also required.