Preclinical modeling of mechanical thrombectomy

Area of Science:

• Biomedical Engineering
• Neurosurgery
• Medical Device Development

Background:

• Mechanical thrombectomy is a highly effective stroke treatment for large vessel occlusions (LVO).
• Preclinical modeling is essential for device design, regulatory approval, and physician training.
• Existing models simulate vascular anatomy and hemodynamics, using patient-derived clot analogues.

Purpose of the Study:

• To review the development of preclinical models for mechanical thrombectomy.
• To focus on clinical translation and identify research gaps.
• To assess the role of preclinical models in device innovation and optimization.

Main Methods:

• In vitro simulations using vascular models and patient-derived emboli.
• Animal models primarily for safety assessment, often in extracranial circulation.
• Computational modeling for concept iteration and workflow optimization.

Main Results:

• In vitro models provide quantitative data on device performance and emboli generation.
• Animal models assess device safety but rarely include the brain.
• Computational models offer rapid characterization of new thrombectomy concepts.

Conclusions:

• Preclinical models, despite limitations, are vital for developing safe and effective mechanical thrombectomy devices.
• Continued research is needed to address existing gaps in preclinical modeling, particularly concerning brain inclusion.
• These models have successfully contributed to the delivery of efficacious devices with excellent clinical outcomes.