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RT Journal Article
SR Electronic
T1 Cyclic Aspiration in Mechanical Thrombectomy: Influencing Factors and Experimental Validation
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1708
OP 1715
DO 10.3174/ajnr.A8369
VO 45
IS 11
A1 Jablonska, Magda
A1 Li, Jiahui
A1 Tiberi, Riccardo
A1 Bayraktar, Esref Alperen
A1 Bilgin, Cem
A1 Tomasello, Alejandro
A1 Ribo, Marc
YR 2024
UL http://www.ajnr.org/content/45/11/1708.abstract
AB BACKGROUND AND PURPOSE: Mechanical thrombectomy is a fundamental intervention for acute ischemic stroke treatment. While conventional techniques are effective, cyclic aspiration (CyA) shows potential for better recanalization rates. We aim to investigate factors affecting CyA and compare them with static aspiration (StA).MATERIALS AND METHODS: StA setup consisted of an aspiration pump connected to pressure transducer. CyA was tested with 5 subsequent iterations: single solenoid valve with air plus saline (i1) or saline alone (i2) as aspiration medium; 2 solenoid valves with air plus saline (i3) as aspiration medium; complete air removal and saline feeding (i4); and pressurized saline feeding (i5). To assess the efficacy of clot ingestion, the pressure transducer was replaced with a distal aspiration catheter. Moderately stiff clot analogs (15 mm) were used to investigate the ingestion quantified as clot relative weight loss. Additionally, the aspiration flow rate was assessed for each setup.RESULTS: With CyA i1, the amplitude of the achieved negative pressure waves declined with increasing frequencies but progressively increased with each subsequent iteration, achieving a maximum amplitude of 81 kPa for i5 at 1 Hz. Relative clot weight loss was significantly higher with i5 at 5 Hz than with StA (100% versus 37.8%; P = .05). Aspiration flow rate was lower with CyA than with StA (i5 at 5 Hz: 199.8 mL/min versus StA: 311 mL/min; P &lt; .01).CONCLUSIONS: CyA with the appropriate setup may represent an encouraging innovation in mechanical thrombectomy, offering a promising pathway for improving efficacy in clot ingestion and recanalization. The observed benefits warrant confirmation in a clinical setting.CyAcyclic aspirationDACdistal aspiration catheterFPRfirst-pass reperfusionMTmechanical thrombectomyStAstatic aspiration