A number of thrombectomy devices using a variety of methods have now been developed to facilitate clot removal. We present research involving one such experimental device recently developed in the UK, called a ‘GP’ Thrombus Aspiration Device (GPTAD). This device has the potential to bring about the extraction of a thrombus. Although the device is at a relatively early stage of development, the results look encouraging. In this work, we present an analysis and modeling of the GPTAD by means of the bond graph technique; it seems to be a highly effective method of simulating the device under a variety of conditions. Such modeling is useful in optimizing the GPTAD and predicting the result of clot extraction. The aim of this simulation model is to obtain the minimum pressure necessary to extract the clot and to verify that both the pressure and the time required to complete the clot extraction are realistic for use in clinical situations, and are consistent with any experimentally obtained data. We therefore consider aspects of rheology and mechanics in our modeling.
The World Health Organization estimates that 17 million people die of cardiovascular disease, particularly heart attacks and strokes, every year. Most strokes are caused by a blood clot that occludes an artery in the cerebral circulation and the process concerning the removal of this obstruction involves catheterisation. The fundamental object of the presented study consists in determining and optimizing the necessary simulation model corresponding with the blood clot zone to be implemented jointly with other Mechanical Thrombectomy Device simulation models, which have become more widely used during the last decade. To do so, a multidomain technique is used to better explain the different aspects of the attachment to the artery wall and between the existing platelets, it being possible to obtain the mathematical equations that define the full model. For a better understanding, a consecutive approximation to the definitive model will be presented, analyzing the different problems found during the study. The final presented model considers an elastic characterization of the blood clot composition and the possibility of obtaining a consecutive detachment process from the artery wall. In conclusion, the presented model contains the necessary behaviour laws to be implemented in future blood clot simulation models.
A study involving the removal of blood clots in cerebral vessels by aspiration thrombectomy is presented. A robust design for the distal end geometry of a catheter is obtained that, together with adequate suction conditions, could avoid potential damage in the artery or fragmentation the thrombus. The optimization process of the parameters is undertaken by a Design of Experiments (DOE) that has been prepared based on Robust Design theories. In particular, 27 experiments are run for one factor at 9 levels (catheter geometry) and up to 9 factors at 3 levels. The experiments are formulated with virtual models that are solved with computing tools. Co-simulation between Computer Fluid Dynamics (CFD) and Finite Elements Method (FEM) structural analysis was used to obtain the suction conditions and the behavior of the blood clot during the intervention process. By comparing the results of the 27 experiments, the highest values of the suctioning force are obtained for a hole pattern based catheter design, that also gives the lowest risk for clot damage (based on the stress value obtained). Direct aspiration and designs based on conical catheter distal ends, give less robust solutions (results are not stable when the conditions of the environment change). Our study investigated the distance between the catheter and the clot, and it was noted that if the catheter was far from the clot, the suction generated a vessel narrowing and consequent potential damage. Up to 90 kPa could be applied when suctioning at a maximum distance equal to the diameter of the vessel between the distal end of the catheter and the proximal end of the clot. A maximum suctioning force of 0,514N was achieved without damage to the artery or the clot. This research enables us to determine and use the most representative parameters and geometries to be tested in in-vitro and in-vivo experiments. In this virtual study, hypothesizes are assumed with regard to the material properties, but the robustness of the design process allows to expect similar results in future in-vitro and in-vivo tests.
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