In vitro models for the experimental evaluation of mechanical thrombectomy devices in acute ischemic stroke

Liu, Ronghui; He, Hong‐Ping; Zhang, Luo; Fan, Yubo; Wang, Jun; Wang, Weidong

doi:10.1177/15910199221118404

Interv Neuroradiol

2022

DOI: 10.1177/15910199221118404

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In vitro models for the experimental evaluation of mechanical thrombectomy devices in acute ischemic stroke

Ronghui Liu

Hong‐Ping He

Luo Zhang

et al.

Abstract: Mechanical thrombectomy has become an important method for the treatment of acute ischemic stroke for large vessel occlusions. The current hotspots of mechanical thrombectomy are optimizing the treatment methods, improving the recanalization rate and reducing complications. The in vitro model has become a common and convenient method for mechanical thrombectomy research. This review summarizes the in vitro model in the following aspects: the preparation of clot analogues; the experimental platform; the applica… Show more

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2024

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Cited by 3 publications

References 67 publications

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Variability in Intracranial Vessel Diameters and Considerations for Neurovascular Models: A Systematic Review and Meta‐Analysis

Mirza,

Kummer,

Touchette

et al. 2024

SVIN

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BACKGROUND In vitro experiments are critical for understanding the impact of medical devices and techniques on blood vessels and blood flow. However, their interpretation is often limited by anatomical models’ inability to capture the wide range of vessel sizes observed in real‐world practice. The current study aims to address this limitation by describing the distribution of vessel diameters in a real‐world population. METHODS This systematic literature review using the PubMed database analyzed cerebral vessel diameters in patients from 2000 to 2022. The diameter measurements of various vessels within the neurovasculature were extracted. Random‐effects meta‐analyses were performed to synthesize vessel diameters across studies. Predicted distributions were generated from the meta‐analytical results. RESULTS Seventy‐six studies were included in the analysis. The M1 segment, internal carotid artery (cervical and communicating segments), A1 segment, V2 segment, V4 segment, and basilar artery had sufficient data for generating predicted distributions of vessel diameters. Predicted mean diameters were as follows: M1 segment, 2.55 ± 0.42 mm (95th interpercentile range [IPR]: 1.71–3.38); internal carotid artery‐cervical segment, 4.74 ± 0.64 mm (95th IPR: 3.49–5.99); internal carotid artery‐communicating segment, 3.40 ± 0.64 mm (95th IPR: 2.15–4.66); A1 segment, 1.89 ± 0.34 mm (95th IPR: 1.23–2.55); V2 segment, 3.36 ± 0.67 mm (95th IPR: 2.05–4.67); V4 segment, 2.42 ± 0.74 mm (95th IPR: 0.98–3.86); and basilar artery, 2.96 ± 0.52 mm (95th IPR: 1.94–3.97). CONCLUSION Cerebral vessel diameter measurements can vary substantially due to patient‐specific factors and imaging techniques. This literature review highlights the diverse range of vessel sizes observed in different patient populations, emphasizing the need for anatomical models that accurately represent clinical observations.

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Variability in Intracranial Vessel Diameters and Considerations for Neurovascular Models: A Systematic Review and Meta‐Analysis

Mirza,

Kummer,

Touchette

et al. 2024

SVIN

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Experimental evaluation of the plunger technique: A method of cyclic manual aspiration thrombectomy for treatment of acute ischemic stroke

Poulos,

Keith,

Froehler

et al. 2024

Interv Neuroradiol

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Background Mechanical thrombectomy via direct aspiration is a rapid treatment for acute ischemic stroke. This method often results in the partial ingestion of the clot or “corking” of the catheter tip. Cyclic aspiration may take advantage of the mechanical properties of the clot, resulting in greater clot ingestion and overall procedure success. Methods An in vitro analysis was performed comparing static and cyclic (plunger technique) aspiration. Embolus analogs were used to create occlusions in a mock circulatory flow loop, and one aspiration attempt (first pass effect) using either a static or plunger technique was performed. The percent ingestion of each embolus analog was recorded for each trial. Results Static aspiration for 0% and 50% hematocrit embolus analogs resulted in ingestions of 12.8 ± 4.6% and 15.1 ± 10.0%, respectively, while plunger technique (cyclic) aspiration resulted in 15.8 ± 7.3% and 34.4 ± 19.5% ingestion. Complete ingestion was observed only with 50% hematocrit analogs, occurring in 30% of plunger and 10% of static cases. Statistical differences were determined between the two aspiration techniques for the 50% hematocrit samples, with the plunger technique yielding significantly more ingestion. In addition, the plunger technique was shown to maintain a negative vacuum pressure throughout the duration of cyclic plunging. Conclusions The plunger technique for manual cyclic aspiration resulted in higher rates of complete ingestion and greater average % ingestions when compared to static aspiration. Increased clot ingestion can result in a higher rate of complete reperfusion during the first aspiration attempt, maximizing the number of patients with good clinical outcomes.

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Manufacturing, Processing, and Characterization of Self-Expanding Metallic Stents: A Comprehensive Review

Vanaei,

Hashemi,

Solouk

et al. 2024

Bioengineering

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This paper aims to review the State of the Art in metal self-expanding stents made from nitinol (NiTi), showing shape memory and superelastic behaviors, to identify the challenges and the opportunities for improving patient outcomes. A significant contribution of this paper is its extensive coverage of multidisciplinary aspects, including design, simulation, materials development, manufacturing, bio/hemocompatibility, biomechanics, biomimicry, patency, and testing methodologies. Additionally, the paper offers in-depth insights into the latest practices and emerging trends, with a special emphasis on the transformative potential of additive manufacturing techniques in the development of metal stents. By consolidating existing knowledge and highlighting areas for future innovation, this review provides a valuable roadmap for advancing nitinol stents.

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In vitro models for the experimental evaluation of mechanical thrombectomy devices in acute ischemic stroke

Cited by 3 publications

References 67 publications

Variability in Intracranial Vessel Diameters and Considerations for Neurovascular Models: A Systematic Review and Meta‐Analysis

Variability in Intracranial Vessel Diameters and Considerations for Neurovascular Models: A Systematic Review and Meta‐Analysis

Experimental evaluation of the plunger technique: A method of cyclic manual aspiration thrombectomy for treatment of acute ischemic stroke

Manufacturing, Processing, and Characterization of Self-Expanding Metallic Stents: A Comprehensive Review

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