Article Text

Download PDFPDF
Original research
Development of physiologically relevant synthetic thrombus for use in visual analysis of in vitro mechanical thrombectomy device testing
  1. Holly Berns1,2,
  2. Sophia Robertson1,2,
  3. Kailey Lewis1,3,
  4. Jesse Wells1,3,
  5. Wyatt Clark1,2,
  6. Timothy A Becker1
    1. 1Mechanical Engineering Department, Northern Arizona University, Flagstaff, Arizona, USA
    2. 2Bioengineering Program, Northern Arizona University, Flagstaff, Arizona, USA
    3. 3Aneuvas Technologies Inc, Flagstaff, Arizona, USA
    1. Correspondence to Dr Timothy A Becker; Tim.Becker{at}nau.edu

    Abstract

    Background Ischemic stroke is a leading cause of death and significant long-term disability worldwide. Mechanical thrombectomy is emerging as a standard treatment for eligible patients. As clinical implementation of stent retrieval and aspiration thrombectomy increases, there is a need for physiologically relevant in vitro device efficacy testing. Critical to this testing is the development of standardized ‘soft’ and ‘hard’ synthetic blood clots that mimic the properties of human thrombi and are compatible with imaging technologies. Synthetic clots allow researchers to extract information regarding clot integration, model hemodynamics, and quantify the physics of thrombectomy.

    Methods This work develops polyacrylamide and alginate-based synthetic clots that are compatible with particle image velocimetry (PIV) and radiographic imaging techniques while maintaining mechanical properties of ‘soft’ and ‘hard’ human clots. Dynamic mechanical analysis testing using an HR2-Rheometer demonstrates comparable mechanical properties to human clots previously tested by this research group and provided in existing literature.

    Results The synthetic clots are formulated with either 0.5% w/v polyethylene microspheres for PIV visualization or 20% w/v barium sulfate for angiographic visualization, enabling real-time imaging of clot behavior during thrombectomy simulations. The soft formulation shows compressive and shear properties of ~12 kPa and 2–3 kPa, respectively. The hard clots are 3–4 times stiffer, with compressive and shear properties of 41–42 kPa and 8-9 kPa, respectively.

    Conclusion Standardized synthetic clots offer a platform for reproducible device testing. This provides a greater understanding of mechanical thrombectomy device efficacy, which may lead to quantifiable advances in device development and eventual improved clinical outcomes.

    • Device
    • Stroke
    • Angiography
    • Catheter
    • Thrombectomy

    Data availability statement

    Data are available upon reasonable request. Additional data from this study include shear and elastic modulus data for synthetic thrombus samples as well as all synthetic thrombus formulations tested across a shear rate range of 1–10 rad/s. A detailed PIV set-up procedure is also available. Additional PIV and angiography images are available. The corresponding author and the authors affiliated with Northern Arizona University can access the data. Data can be obtained by contacting the corresponding author (TAB).

    Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request. Additional data from this study include shear and elastic modulus data for synthetic thrombus samples as well as all synthetic thrombus formulations tested across a shear rate range of 1–10 rad/s. A detailed PIV set-up procedure is also available. Additional PIV and angiography images are available. The corresponding author and the authors affiliated with Northern Arizona University can access the data. Data can be obtained by contacting the corresponding author (TAB).

    View Full Text

    Footnotes

    • Contributors HB, SR, KL, JW, TAB contributed to the conception, design, acquisition, analysis, or interpretation of the data. HB, SR, KL, JW, WC, TAB drafted or revised the manuscript for intellectual content. HB, SR, KL, JW, WC, TAB approved the final version for publication. HB and TAB agreed to be accountable for all aspects of the work.

    • Funding This work was supported by a STTR grant from the NIH (grant #1R41NS132732-01).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.