Platelet plug microstructure and flow modulate fibrin gelation dynamics: Insights from computational simulations

TL;DR

This study presents a novel computational model to understand how platelet microstructure and blood flow influence fibrin gelation during thrombus formation, revealing the complex interplay affecting clot stability.

Contribution

The paper introduces a new 2D computational framework integrating platelet microstructure, coagulation, and fibrin polymerization to study clot formation under flow conditions.

Findings

Gelation initiates faster in denser platelet plugs.

Fibrin formation varies spatially depending on plug density and flow.

Dense plugs promote peripheral gelation, affecting clot stability.

Abstract

During the formation of a thrombus, the architecture of the growing platelet aggregate is heterogeneous, with areas of dense and loosely packed platelets. The surface of activated platelets facilitate biochemical coagulation reactions that ultimately result in the formation of a fibrin network which stabilizes the thrombus. How platelet-plug microstructure and flow jointly govern the onset and development of fibrin is incompletely understood. We developed a novel 2D computational framework that integrates (1) a pre-adhered, discrete platelet aggregate, (2) a reduced coagulation model that generates thrombin, and (3) a fibrin polymerization model. Three platelet-plug configurations were constructed with prescribed interplatelet gaps and simulations were performed with various wall shear rates. We quantified spatiotemporal clotting metrics, including coagulation factor concentrations, fibrin evolution, and gelation onset. Across geometries, gelation initiation accelerated with increasing plug density. For more dense geometries, gelation emerged first near the plug periphery. As the platelet density increased, intraplug transport was increasingly restricted and the thrombin concentrations in between platelets increased. In contrast, the loose plug supported fibrinogen replenishment deeper into the plug core. Despite slower coagulation initiation due to reduced platelet surface area, monomer generation persisted in the interior, causing gelation to begin at the vessel wall. These results suggest a mechanistic tradeoff: rapid sealing of the injured vessel wall by early platelet contraction, i.e. plug densification, may impede the intraplug fibrin formation needed for durable stabilization. The proposed model provides a basis for studies of platelet-coagulation interactions under flow, including therapeutic developments relevant to prevention of cardiovascular disease.