Combined stent-retriever and aspiration intra-arterial thrombectomy performance for fragmentable blood clots: A proof-of-concept computational study

Giulia Luraghi*, Sara Bridio, Vittorio Lissoni, Gabriele Dubini, Anushree Dwivedi, Ray McCarthy, Behrooz Fereidoonnezhad, Patrick McGarry, Frank J.H. Gijsen, Jose Felix Rodriguez Matas, Francesco Migliavacca

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Mechanical thrombectomy (MT) treatment of acute ischemic stroke (AIS) patients typically involves use of stent retrievers or aspiration catheters alone or in combination. For in silico trials of AIS patients, it is crucial to incorporate the possibility of thrombus fragmentation during the intervention. This study focuses on two aspects of the thrombectomy simulation: i) Thrombus fragmentation on the basis of a failure model calibrated with experimental tests on clot analogs; ii) the combined stent-retriever and aspiration catheter MT procedure is modeled by adding both the proximal balloon guide catheter and the distal access catheter. The adopted failure criterion is based on maximum principal stress threshold value. If elements of the thrombus exceed this criterion during the retrieval simulation, then they are deleted from the calculation. Comparison with in-vitro tests indicates that the simulation correctly reproduces the procedures predicting thrombus fragmentation in the case of red blood cells rich thrombi, whereas non-fragmentation is predicted for fibrin-rich thrombi. Modeling of balloon guide catheter prevents clot fragments' embolization to further distal territories during MT procedure.

Original languageEnglish
Article number105462
JournalJournal of the Mechanical Behavior of Biomedical Materials
Volume135
DOIs
Publication statusPublished - Nov 2022

Bibliographical note

Funding Information:
This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 777072 and from the MIUR FISR-FISR2019_03221 CECOMES.

Publisher Copyright: © 2022 Elsevier Ltd

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