en
Scientific article
Open access
English

Can micro-guidewire advancement forces predict clot consistency and location to assist the first-line technique for mechanical thrombectomy ?

Publication date2024-04-18
First online date2024-04-18
Abstract

Background

The identification of specific clot characteristics before mechanical thrombectomy (MTB) might allow the selection of the most effective first-line technique, thus potentially improving the procedural outcome. We aimed to evaluate if the microwire push forces could extrapolate information on clot consistency and extension before MTB, based on clot mechanical properties.

Methods

We measured in vitro the forces exerted on the proximal extremity of the guidewire during the advancement and retrieval of the guidewire through clot analogs of different compositions. In addition, we analyzed the forces exerted on the guidewire to extrapolate information about the location of the proximal and distal extremities of the clot analogs.

Results

The maximum forces recorded during the whole penetration phase were significantly different for hard and soft clots (median values, 55.6 mN vs 15.4 mN, respectively; P<0.0001). The maximum slope of the force curves recorded during the advancement of the guidewire for the first 3 s of penetration also significantly differentiated soft from hard clot analogs (7.6 mN/s vs 23.9 mN/s, respectively; P<0.0001). In addition, the qualitative analysis of the shape of the force curves obtained during the advancement and retrieval of the guidewire showed a good potential for the identification of the proximal and distal edges of the clot analogs.

Conclusion

Our results demonstrated that it was possible to differentiate between soft and hard clot analogs. Furthermore, force measurements could give important information about the location of the clot extremities. Such an approach might support the selection of the first-line MTB technique, with the potential to improve the outcome.

eng
Keywords
  • Intracranial Thrombosis
  • Stroke
  • Thrombectomy
Citation (ISO format)
REYMOND, Philippe et al. Can micro-guidewire advancement forces predict clot consistency and location to assist the first-line technique for mechanical thrombectomy ? In: Journal of neurointerventional surgery, 2024. doi: 10.1136/jnis-2024-021477
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal1759-8478
17views
2downloads

Technical informations

Creation04/21/2024 1:51:11 PM
First validation05/30/2024 1:31:33 PM
Update time05/30/2024 1:31:33 PM
Status update05/30/2024 1:31:33 PM
Last indexation05/30/2024 1:31:54 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack