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Clotting in cerebral aneurysms can either serve to stabilise an aneurysm, or can accelerate the time to rupture. In the former case, it is thought that a fully occlusive clot is likely to reduce complex haemodynamic conditions within the aneurysm sac, thereby reducing the chances of rupture. In cases where the clot fills the aneurysm sac partially, further vascular wall degradation has been observed, thus accelerating the time to rupture. The aim of this study is to determine the relative contributions of mechanical processes and biochemistry in the process of cerebral aneurysm clot development. An idealised model of an aneurysm was developed and used as the geometry of interest. This made it possible to make comparisons without a strong dependence on the peculiarities of a specific patient's case. The CFD-ACE+ Multiphysics Package (ESI Group, Paris, France) was used to calculate flow and account for the transport and reaction of biochemical species that contribute to the clotting process. In addition, user-defined functions were used to write a code that coupled the flow, biochemistry and level-set methods, which made it possible to track the surface of the growing clot, and distinguish between normal and clotted blood. The model was then used to examine the relative contributions of mechanics and biochemistry to the initiation and progression of clotting. It was found that the process of clot initiation is governed mainly by mechanical processes. Biochemistry plays a greater role in the progression of the clot where thrombin, the key player in thrombosis contributes to the formation of fibrin and thus, to the stability of the clot.

RELATIVE ROLES OF MECHANICS AND BIOCHEMISTRY IN THE INITIATION AND PROGRESSION OF CEREBRAL ANEURYSM THROMBOSIS