Related Experiment Video
Updated: Nov 12, 2025
Particle Image Velocimetry Investigation of Hemodynamics via Aortic Phantom
Published on: February 25, 2022
Impacts on Thrombus and Chordae Willisii During Mechanical Thrombectomy in the Superior Sagittal Sinus
Yuanliang Ye1, Jiuyang Ding2, Shoutang Liu1
1Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, China.
Insights
Mechanical thrombectomy (MT) for superior sagittal sinus (SSS) clots generates emboli and can increase residual thrombus. While stents cause minor damage to chordae tendineae (CW), repeated MT procedures worsen outcomes.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Medical Device Engineering
Background:
- Mechanical thrombectomy (MT) is used for superior sagittal sinus (SSS) thrombosis but can cause complications.
- The mechanisms of SSS damage and new thrombosis during MT are not fully understood.
- Chordae tendineae (CW) are delicate structures within the SSS potentially at risk during MT.
Purpose of the Study:
- To investigate the risks of embolism during MT in the SSS.
- To assess damage to CW when using a stent for thrombus removal.
- To evaluate the impact of repeated MT procedures on residual thrombus.
Main Methods:
- An in vitro contrast-enhanced model simulating MT in the SSS was utilized.
- Thrombus removal was performed using a stent, with emboli collected and measured.
- Residual thrombus area was quantified using J Image software, and CW damage was assessed via endoscopy.
Main Results:
- Significant numbers of emboli particles were generated, with fewer large particles in later procedures.
- Residual thrombus area increased with multiple MT procedures on the same sample.
- Minor CW damage occurred in 90.16% of cases, with serious damage in 9.84%; stent use did not significantly increase CW damage.
Conclusions:
- MT in the SSS generates considerable thrombi particles, posing embolism risks.
- Repeated MT procedures increase residual thrombus, potentially leading to re-occlusion.
- Stent-assisted MT causes minor CW damage but is not associated with significantly increased injury.
Abstract:
The anatomical structures of the superior sagittal sinus (SSS) are usually damaged during mechanical thrombectomy (MT), and MT procedure could lead to new thrombosis in the sinuses. However, the mechanism remains unclear. We aimed to investigate the risks of embolism and assess the damage to chordae willisii (CW)-associated MT using a stent passing across the thrombus. A contrast-enhanced in vitro model was used to mimick MT in the SSS. The thrombus was removed with a stent. The emboli generated during the procedure were collected and measured. The residual thrombus area after the MT was measured by J Image software. The damage of CW was evaluated by an endoscope. Three procedural experiments were carried out on each cadaveric sample. The average numbers of visible emboli particles in experiments 1, 2, and 3 were 11.17 ± 2.17, 9.00 ± 2.07, and 5.00 ± 2.96, respectively. The number of large size particles produced by experiment 1 was significantly higher than that of the other experiments. The thrombus area measured after experiment 3 was larger than that of experiments 1 and 2. The number of minor damage cases to CW was 55 (90.16%), and there were six serious damage cases (9.84%). The use of stent resulted in no significant increase in damage to CW after the three experimental procedures. A large amount of thrombi particles was produced during MT, and multiple MT procedures on the same sample can increase residual thrombus area. Moreover, the stent caused minor damages to the CW in SSS.
