The Impact of Thromboemboli Histology on the Performance of a Mechanical Thrombectomy Device

作者：Ichiro Yuki, Issei Kan, Harry V. Vinters, R.H. Kim, Alireza Golshan, Fernando Viñuela, James William Sayre, Yuichi Murayama, Fernando Viñuela · 发表于：American Journal of Neuroradiology · 年份：2011 · DOI：10.3174/ajnr.a2842 · 被引用次数：165 · 研究领域：Acute Ischemic Stroke Management、Hemostasis and retained surgical items、Blood properties and coagulation

BACKGROUND AND PURPOSE: Recently we published a novel method of thrombus preparation for use in a swine model for evaluation of thrombectomy designs. The clot (fibrin rich clot) is characterized by its similarity in histologic characteristics to the thromboemboli recovered from stroke patients. The purpose of this latest study was to evaluate if the performance of a mechanical thrombectomy device was affected by the histologic characteristics of thromboembolus. Erythrocyte rich clot, which was created using exogenous thrombin, and the novel experimental clot with abundance of fibrin/cellular component were used for comparison. The Merci clot retriever was used for the evaluation and the angiographic outcomes were analyzed. MATERIALS AND METHODS: Two histologically different types of experimental clot, a conventionally used thrombin-induced clot (erythrocyte-rich clot) and a novel experimental clot that is similar in histologic characteristics to the thromboemboli recovered from patients with stroke (fibrin-rich clot), were prepared. Eight extracranial arteries in swine were occluded with erythrocyte-rich clot (group A), and 8 were occluded with fibrin-rich clot (group B), and MT by using the Merci clot retriever device was performed. Angiographic results in each group were evaluated. RESULTS: A total of 48 attempts at MT were made. The average number of attempts to achieve TIMI grade II or III recanalization was 2.75 times in group A and 4.5 times in group B (P < .001), respe...