Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA.
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105205. doi: 10.1016/j.jstrokecerebrovasdis.2020.105205. Epub 2020 Aug 7.
As access to patient emboli is limited, embolus analogs (EAs) have become critical to the research of large vessel occlusion (LVO) stroke and the development of thrombectomy technology. To date, techniques for fabricating standardized human blood-derived EAs are limited in the variety of compositions, and the mechanical properties relevant to thrombectomy are not quantified.
EAs were made by mixing human banked red blood cells (RBCs), plasma, and platelet concentrate in 10 different volumetric percentage combinations to mimic the broad range of patient emboli causing LVO strokes. The samples underwent histologic analysis and tensile testing to mimic the pulling action of thrombectomy devices, and were compared to patient emboli.
EAs had histologic compositions of 0-96% RBCs, 0.78%-92% fibrin, and 2.1%-22% platelets, which can be correlated with the ingredients using a regression model. At fracture, EAs elongated from 81% to 136%, and the ultimate tensile stress ranged from 16 to 949 kPa. These EAs' histologic compositions and tensile properties showed great similarity to those of emboli retrieved from LVO stroke patients, indicating the validity of such EA fabrication methods. EAs with lower RBC and higher fibrin contents are more extensible and can withstand higher tensile stress.
EAs fabricated and tested using the proposed new methods provide a platform for stroke research and pre-clinical development of thrombectomy devices.
由于获取患者栓子的途径有限,栓子模拟物(EAs)对于研究大血管闭塞(LVO)性卒中以及开发取栓技术变得至关重要。迄今为止,制造标准化人血来源的 EAs 的技术在组成的多样性方面受到限制,并且与取栓术相关的机械性能也未被量化。
通过将人血库存储的红细胞(RBCs)、血浆和血小板浓缩物以 10 种不同的体积百分比组合混合,来制作 EAs,以模拟导致 LVO 性卒中的广泛范围的患者栓子。这些样本进行了组织学分析和拉伸测试,以模拟取栓设备的拉动作用,并与患者栓子进行了比较。
EAs 的组织学组成范围为 0-96%RBCs、0.78%-92%纤维蛋白和 2.1%-22%血小板,可以使用回归模型将其与成分相关联。在断裂时,EAs 伸长了 81%-136%,极限拉伸应力范围为 16-949kPa。这些 EAs 的组织学组成和拉伸性能与从 LVO 性卒中患者中取出的栓子非常相似,表明了这种 EAs 制造方法的有效性。RBC 含量较低且纤维蛋白含量较高的 EAs 更具延展性,可以承受更高的拉伸应力。
使用提出的新方法制造和测试的 EAs 为卒中研究和取栓设备的临床前开发提供了一个平台。