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Mathematics and thrombolysis: Role of the mathematical modelling in understanding and developing blood clot fragmentation

      Nowadays, systemic thrombolysis remains the cornerstone in the treatment of different life-threatening arterial occlusive disease as ischemic stroke and pulmonary embolism (PE). Conversely, its use has scale down over the years in the treatment of acute myocardial infarction (AMI) after the wide diffusion of percutaneous coronary artery intervention (PCI) and Cath-labs [
      • Zuin M.
      • Rigatelli G.
      • Faggian G.
      • L'Erario R.
      • Chinaglia M.
      • Roncon L.
      Could advance drug delivery systems be the future in cardiovascular revascularization medicine?.
      ]. Thrombolytic treatments have been widely investigated both from a clinical and biochemical point of view [
      • Knuttinen M.G.
      • Emmanuel N.
      • Isa F.
      • Rogers A.W.
      • Gaba R.C.
      • Bui J.T.
      • et al.
      Review of pharmacology and physiology in thrombolysis interventions.
      ]. However, the rheological properties of thrombolytic agents are often not well known or ignored by physicians since their description require the understanding of complex mathematical models. Moreover, most of these investigations have been often published in in biophysics or math journals, which are generally not of interest for physicians. The physical and rheological properties of thrombolytic agents have been studied both in-vivo and in-vitro using different imaging modalities as optical photography and magnetic resonance imaging (MRI) [
      • Tratar G.
      • Blinc A.
      • Strukelj M.
      • Mikac U.
      • Sersa I.
      Turbulent axially directed flow of plasma containing rt-PA promotes thrombolysis of non-occlusive whole blood clots in vitro.
      ,
      • Sakharov D.V.
      • Rijken D.C.
      The effect of flow on lysis of plasma clots in a plasma environment.
      ]. Why a physician should be interested in the physic properties of thrombolytic agents? Because the knowledge of the interaction between the drug and the thrombus could be helpful to understand and even explain some events which can occur in their daily clinical practice.

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