RESUMEN
Mechanical thrombectomy is a minimally invasive interventional method. Embolization device is too close to the blood vessel wall and venous valve in clinical applications, and it can cause blood vessel damage when it is sucked into the lumen. Embolization device is easy to cause hemolysis. Optimal design can reduce the damage to red blood cells, but it cannot be completely avoided; Shedding emboli can complicate the pulmonary artery. The clinical application studies of mechanical thrombectomy devices in the world was reviewed, including 74 experimental studies and 166 clinical application studies. The current status and causes of vascular injury, hemolysis and pulmonary embolism caused by mechanical thrombectomy were analyzed. This paper aims to make recommendations for the optimization of mechanical thrombectomy devices.
RESUMEN
Objective To investigate the influence of thrombus entrance shape, suction rate and blood flow velocity on thrombus aspiration of rotary cutting and suctioned thrombectomy devices, so as to provide theoretical support for the design and optimization of such devices. Methods Three models with different thrombus entrance shapes (‘L’-style, ‘8’-style and ‘0’-style) were established to study the influence of thrombus entrance shape on the thrombectomy; different suction rates (75, 100, 125, 150 mL/min) and different blood flow velocities (0-10 cm/s, at interval of 1 cm/s) were set to discuss how the suction rate and blood flow velocity affected the thrombectomy based on ‘8’-style thrombus entrance. Results The thrombus could not be aspirated evenly in ‘L’-style model, and there was no significantly difference in aspiration between ‘8’ -style model and ‘0’-style model. But the ‘8’-style model was better than ‘0’-style model in lateral thrombus suction. The suction rate that was greater than 100 mL/min provided a limited effect on improvement of thrombectomy effect. The best suction effect was reached when blood flow velocity was less than 1 cm/s, and the effect of thrombectomy was decreasing gradually with blood flow velocity increasing. Conclusions The thrombus entrance shape, suction rate and blood flow velocity had a great impact on thrombectomy greatly. A wide and short thrombus entrance shape, an appropriate increase of suction rate and decrease of blood flow velocity would contribute significantly to the improvement of thrombectomy effect. These results can be used as guidance for the optimal design of rotary cutting and suctioned thrombectomy devices.
RESUMEN
Mechanical thrombectomy is a minimally invasive interventional method. Embolization device is too close to the blood vessel wall and venous valve in clinical applications, and it can cause blood vessel damage when it is sucked into the lumen. Embolization device is easy to cause hemolysis. Optimal design can reduce the damage to red blood cells, but it cannot be completely avoided; Shedding emboli can complicate the pulmonary artery. The clinical application studies of mechanical thrombectomy devices in the world was reviewed, including 74 experimental studies and 166 clinical application studies. The current status and causes of vascular injury, hemolysis and pulmonary embolism caused by mechanical thrombectomy were analyzed. This paper aims to make recommendations for the optimization of mechanical thrombectomy devices.