A Thrombectomy Model Based on Ex Vivo Whole Human Brains

The persistent challenges in thrombectomy for large-vessel occlusion, such as suboptimal complete recanalization and first-pass effect imply an insufficient understanding of the artery-clot-device interaction. In this study, we present a thrombectomy model using fresh human brains, which can capture...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2021-11, Vol.42 (11), p.1968-1972
Main Authors: Liu, Y, Larco, J L A, Madhani, S I, Shahid, A H, Quinton, R A, Kadirvel, R, Kallmes, D F, Brinjikji, W, Savastano, L E
Format: Article
Language:English
Subjects:
Brain - diagnostic imaging
Brain - surgery
Editor's Choice
Embolization, Therapeutic
Humans
Interventional
Stroke - therapy
Thrombectomy
Thrombosis
Treatment Outcome
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Summary:The persistent challenges in thrombectomy for large-vessel occlusion, such as suboptimal complete recanalization and first-pass effect imply an insufficient understanding of the artery-clot-device interaction. In this study, we present a thrombectomy model using fresh human brains, which can capture the artery-clot-device interaction through concurrent transmural and angiographic visualizations. Fresh nonfrozen whole adult human brains were collected and connected to a customized pump system tuned to deliver saline flow at a physiologic flow rate and pressure. Angiography was performed to verify the flow in the anterior-posterior and vertebrobasilar circulations and collaterals. Large-vessel occlusion was simulated by embolizing a radiopaque clot analog. Thrombectomy was tested, and the artery-clot-device interactions were recorded by transmural and angiographic videos. Baseline cerebral angiography revealed excellent penetration of contrast in the anterior-posterior and vertebrobasilar circulations without notable arterial cutoffs and with robust collaterals. Small branches (
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A7291