Mechanical Thrombectomy and Development of Thrombectomy Devices

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Background

Today, mechanical thrombectomy plays an essential role in treating stroke related to major vessel occlusion. The device technology has been evolving in the past decade from the first-generation device of clot retriever (Merci Clot Retrieval System) to stent retrievers and aspiration catheters. With the quality of aspiration catheters improving every year, the treatment strategy has been changing dramatically. Therefore, to improve the efficacy and safety of the new generation devices, preclinical evaluation of the prototype devices using experimental models under the imaging guidance becomes crucial.

Various experimental models have been proposed by investigators for the simulation of mechanical thrombectomy. For instance, patient-specific silicon models based on the 3D reconstruction of vessel segments, clinically-representative artificial clot models with various compositional and mechanical features, e.g. (fibrin rich clot, erythrocyte rich clot or mixture of each), and animal models using swine, ovine and canine.

This Research Topic aims at collecting contributions of leading researchers of each field and seeking the most updated knowledge on each topic. This Research topic will delineate the trend and workflow of how the prototype devices are investigated and launched as new devices to improve the technical success rate and safety.

Thus, topic editors will welcome any types of manuscripts - research article, brief research article, review, and mini-review- about, but not limited to the following themes:

• Development of experimental models (in vitro) for the evaluation of mechanical thrombectomy devices (Authors can describe the conventional in-vitro models or the latest models (such as 3D silicon models with pulsatile flow circulatory system) for the evaluation of thrombectomy devices)

• Development of experimental clot models: compositions and mechanical properties of each clot type, with a discussion of their advantages and limitations

• Development of animal models (in vivo) for evaluating mechanical thrombectomy devices (e.g., description of different animals, different vessels, and clot models used for the evaluations; The advantage/limitations of each model)

• The initial clinical experiment of the newest thrombectomy devices(e.g., authors can share the initial clinical experience (pilot studies) related to the new generation thrombectomy device.)

• Advanced imaging in acute ischemic stroke diagnosis and management (clinical use). For preclinical device assessment, high-resolution cone-beam CT can be used to evaluate the clot-device interaction. Recently, both single-energy and dual-energy CT have been employed in clot characterization.

• Determination of mechanical thrombectomy strategies for successful recanalization. For example, many treatment strategies were proposed and discussed in the previous publications, such as Dual SAVE and TRAP techniques. What are the pros and cons of each technique and when to use them?

Keywords: Mechanical Thrombectomy, Stroke, Device development, experimental models, animal models

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