A Thrombectomy Model Based on Ex Vivo Whole Human Brains

Area of Science:

• Biomedical Engineering
• Neurointerventional Radiology
• Medical Device Development

Background:

• Thrombectomy for large-vessel occlusion faces challenges like incomplete recanalization.
• Understanding artery-clot-device interaction is crucial for improving thrombectomy outcomes.
• Current models lack the fidelity to fully capture these complex interactions.

Purpose of the Study:

• To develop and validate a novel thrombectomy model using fresh human brains.
• To concurrently visualize artery-clot-device interactions using transmural and angiographic methods.
• To gain critical insights into the mechanisms and failure modes of thrombectomy devices.

Main Methods:

• Utilized fresh, nonfrozen adult human brains connected to a physiologic pump system.
• Simulated large-vessel occlusion using a radiopaque clot analog.
• Recorded artery-clot-device interactions via concurrent transmural and angiographic video.

Main Results:

• Established a functional cerebral circulation model with robust collateralization.
• Observed thrombectomy device passes, noting failure modes like elongation, fragmentation, and distal embolization.
• Demonstrated the model's capability to capture detailed interactions during simulated thrombectomy.

Conclusions:

• The developed human brain model enables detailed analysis of artery-clot-device interactions.
• Provides critical insights into the action mechanisms of thrombectomy devices.
• Facilitates the evaluation of failure modes for current and novel thrombectomy technologies.