Wolverhampton University, Wolverhampton, West Midlands, United Kingdom.
J Stroke Cerebrovasc Dis. 2010 Mar;19(2):121-9. doi: 10.1016/j.jstrokecerebrovasdis.2009.03.017.
Mechanical thrombectomy can restore blood flow to the brain after acute ischemic stroke, but may be associated with risks, such as breakage of moving parts and clot fragmentation. The aim of this study was to evaluate a new aspiration thrombus device (ATD), the GP ATD, which has no moving parts and extracts clots by suction in a vortex flow pattern.
The GP ATD is used to extract porcine blood clots inserted into the middle cerebral artery (MCA) of a model of the circle of Willis, and from porcine aorta.
The GP ATD is navigable around the acute angles of the circle of Willis model and successfully extracts clots that cause complete occlusion of the MCA. There is a strong correlation between the pressure required for clot extraction (mean 31.8, range 30-34 kPa) and its mass (mean 0.08, range 0.03-0.13 g). Complete clot extraction can be demonstrated by computed tomography scanning. Lysis of a 0.15-g thrombus using alteplase at a concentration of 3.4 microg/mL was more effective when delivered and extracted via the GP ATD than via a catheter without the GP ATD or delivered systemically in our circle of Willis model and extracted without suction (clot mass after extraction 0.07, 0.09, and 0.11 g, respectively). Histologic examination does not show evidence of damage of the arterial wall caused by clot extraction at suction pressures of up to 30 kPa via the GP ATD.
The GP ATD appears to effectively extract blood clots from models of the MCA without significant clot fragmentation and damage to the arterial wall. Further experiments using arteries in situ are required to confirm these findings.
机械取栓可以恢复急性缺血性卒中后的脑血流，但可能存在风险，如活动部件断裂和血栓碎片。本研究旨在评估一种新的抽吸血栓装置（ATD），即 GP ATD，它没有活动部件，通过涡流抽吸模式提取血栓。
GP ATD 用于提取插入 Willis 环模型的大脑中动脉（MCA）和猪主动脉的猪血血栓。
GP ATD 可在 Willis 环模型的锐角周围导航，并成功提取导致 MCA 完全闭塞的血栓。血栓提取所需的压力（平均 31.8kPa，范围 30-34kPa）与其质量（平均 0.08g，范围 0.03-0.13g）之间存在很强的相关性。通过计算机断层扫描可以证明完全提取血栓。当在浓度为 3.4μg/mL 的阿替普酶下通过 GP ATD 输送和提取时，对 0.15g 血栓的溶解比通过没有 GP ATD 的导管或在我们的 Willis 环模型中系统地输送并在没有抽吸的情况下提取更有效（提取后血栓质量分别为 0.07、0.09 和 0.11g）。组织学检查未显示在通过 GP ATD 在 30kPa 的抽吸压力下从 MCA 模型中提取血栓时动脉壁损伤的证据。
GP ATD 似乎可以有效地从 MCA 模型中提取血栓，而不会导致明显的血栓碎片和动脉壁损伤。需要使用原位动脉进一步实验来证实这些发现。
