The standard care of acute ischemic stroke victims involves administration of thrombolytic agents. However, when thrombolytics are contraindicated or the thrombus is large, doctors resort to endovascular thrombectomy which typically involves running a catheter to the site of the blockage and using one of the several marketed devices to remove the clot.
Researchers have now created an artificial blood vessel that can be used to study both the application and effects of the devices used for clot removal. These findings could have implications for future development of endovascular technologies.
Dr. Alexander Khalessi, director of endovascular neurosurgery and surgical director of neurocritical care at the University of California - San Diego Health System said, "This work offers significant promise going forward. The artificial model could represent a practical, scalable and physiological alternative to existing technologies. For example, in treating cerebrovascular disease that covers a group of dysfunctions related to blood supply to the brain, doctors in certain cases must perform endovascular thrombectomies where they mechanically remove the emboli or clots. The rate of endovascular thrombectomies is rising, but the approach can be improved. Current pre-clinical analyses of any new therapeutic approach or device is limited to either in vitro glass or plastic tube testing intended to mimic biological counterparts or by using animal models, such as pigs. Both of these have significant drawbacks."
The researchers have developed a novel in vitro live-cell platform that allows direct visual characterization of effects and injury patterns to endothelial cells (ECs). Using this they tested various clot-retrieval devices and examined the post-removal effects. Dr. Khalessi said, "We found that the in vitro platform permitted high-resolution quantification and characterization of the pattern and timing of EC injury with various thrombectomy devices and vessel diameters. The devices each displayed different effects." Thereafter, the researchers validated their in vitro findings with in vivo testing.
The findings appear online in Stroke