Biomechanical models for studying collateral blood flow and tension in deep veins occlusion of the lower extremities

The relevance of the study is due to the high prevalence of venous thromboembolic complications worldwide and the need for an interdisciplinary in-depth study and improvement of the approach to diagnostic, therapeutic, and preventive measures for acute deep vein thrombosis. There are relatively few scientific studies on collateral blood flow, which is an important mechanism for compensating for venous circulation disorders. In this regard, a computer modeling technique was applied in the SolidWorks environment, which allowed us to study the collateral blood flow in different veins of the lower extremities and the level of tension in the popliteal vein and before the complete occlusion of the common femoral vein in a patient who had suffered acute ileofemoral thrombosis. The work was based on computer tomograms and angiograms, which were interpreted using the Micro Dicom program. Computer biomechanical 3D models of veins with thrombotic masses are constructed according to tomogram slices in the SolidWorks program. The analysis of flow pressure and tension in deep and subcutaneous veins of the lower extremities is carried out. The article shows that collateral veins perform the function of alternative paths for venous blood outflow, their lumen and capacity can increase in conditions of hemodynamic disorders. The greatest effect on the popliteal vein and the common femoral vein is caused by thrombosis of the small saphenous vein due to the peculiarities of anatomy and a smaller number of collaterals, the tension increases by 2.3 and 1.6 times, respectively. The materials of the article are of practical value for vascular surgeons, phlebologists, cardiac surgeons.

1. Whing J., Nandhra S., Nesbitt C., Stansby G. Interventions for Great Saphenous Vein Incompetence. Cochrane Database of Systematic Reviews. 2021;8(8). https://doi.org/10.1002/14651858.CD005624.pub4

2. Yarovenko G.V., Katorkin S.E. Changes in the Cardiovascular System in Post-Thrombotic Syndrome Occlusion Stage of the Lower Extremities. RMJ. 2023;(5):2–5. (In Russ.).

3. Lu J., Fang Q., Ge X. Role and Mechanism of mir-5189-3p in Deep Vein Thrombosis of Lower Extremities. Annals of Vascular Surgery. 2021;77:288–295. https://doi.org/10.1016/j.avsg.2021.07.004

4. Innocenti F., Lazzari C., Ricci F., Paolucci E., Agishev I., Pini R. D-Dimer Tests in the Emergency Department: Current Insights. Open Access Emergency Medicine. 2021;13:465–479. https://doi.org/10.2147/OAEM.S238696

5. Vinay K., Nagaraj K., Arvinda H.R., Vikas V., Rao M. Design of a Device for Lower Limb Prophylaxis and Exercise. IEEE Journal of Translational Engineering in Health and Medicine. 2020;9. https://doi.org/10.1109/JTEHM.2020.3037018

6. Meissner M.H., Moneta G., Burnand K., et al. The Hemodynamics and Diagnosis of Venous Disease. Journal of Vascular Surgery. 2007;46(Suppl. S):4S–24S. https://doi.org/10.1016/j.jvs.2007.09.043

7. Huisman L.C., Den Bakker C., Wittens C.H.A. Microcirculatory Changes in Venous Disease. Phlebology. 2013;28(Suppl. 1):73–78. https://doi.org/10.1177/0268355513477025

8. Anisimov A.V., Kapustin B.B., Mashkovtceva G.V., Kuznetcov P.A. New Method of Diagnostic State of Regional Blood Flow of the Lower Limbs. Modern Problems of Science and Education. 2010;(2):24–27. (In Russ.).

9. Tseng Yu.-H., Chen Ch.-W., Wong M.-Y., et al. Blood Flow Analysis of the Great Saphenous Vein in the Su-Pine Position in Clinical Manifestations of Varicose Veins of Different Severities: Application of Phase-Contrast Magnetic Resonance Imaging Data. Diagnostics. 2022;12(1). https://doi.org/10.3390/diagnostics12010118

10. Vlasov T.D., Yashin S.M. Arterial and Venous Thrombosis. Is the Virchow’s Triad Always Valid? Regional Blood Circulation and Microcirculation. 2022;21(1):78–86. (In Russ.). https://doi.org/10.24884/1682-6655-2022-21-1-78-86