Department of Biomedical Engineering, Pennsylvania State University, 530 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA.
Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA, USA.
Cardiovasc Eng Technol. 2020 Dec;11(6):689-698. doi: 10.1007/s13239-020-00503-w. Epub 2020 Nov 18.
Previous studies have suggested improved recanalization efficiency by using cyclic aspiration as opposed to static aspiration for mechanical thrombectomy in the treatment of acute ischemic stroke (AIS). However, there has not been an investigation into which parameters optimize this theoretical approach. Therefore, this study was designed to investigate the application of static and cyclic pressure in AIS aspiration catheters.
An experimental flow system was designed to apply and measure both static and cyclic aspiration pressures in four commercial aspiration catheters. A medical aspirator and solenoid-valve were used to generate a range of applied pump pressures and cyclic valve frequencies. The measured mean and oscillatory pressure amplitudes were analyzed and compared across catheters and operating conditions.
The greatest mean pressures and forces were achieved under contact-aspiration conditions using the largest diameter catheter, while the largest oscillating pressure (ΔP) and force (ΔF) values were generated in the least compliant catheter, determined to be proportional to both its inner radius and wall thickness. Furthermore, lower frequency cyclic aspiration was able to generate the largest values of ΔP and ΔF.
For future investigations of cyclic aspiration AIS therapy, the best options are to use large inner diameter and low compliance catheters operating at lower cyclic frequencies to generate the greatest mean and oscillating forces on lodged thromboemboli.
先前的研究表明，与机械血栓切除术治疗急性缺血性脑卒中（AIS）中的静态抽吸相比，使用循环抽吸可提高再通效率。然而，尚未研究哪些参数可以优化这种理论方法。因此，本研究旨在探讨静态和循环压力在 AIS 抽吸导管中的应用。
设计了一个实验性流动系统，以在四种商业抽吸导管中应用和测量静态和循环抽吸压力。使用医用抽吸器和电磁阀来产生一系列应用的泵压和循环阀频率。分析并比较了在导管和操作条件下的测量平均和振荡压力幅度。
在使用最大直径导管的接触抽吸条件下，获得了最大的平均压力和力，而在最不顺应性导管中产生了最大的振荡压力（ΔP）和力（ΔF）值，这被确定与导管的内半径和壁厚成正比。此外，较低频率的循环抽吸能够产生最大的ΔP 和 ΔF 值。
对于未来循环抽吸 AIS 治疗的研究，最佳选择是使用大内径和低顺应性导管，以较低的循环频率运行，以对滞留的血栓产生最大的平均和振荡力。
