TY - JOUR
T1 - The first virtual patient-specific thrombectomy procedure
AU - Luraghi, Giulia
AU - Bridio, Sara
AU - Rodriguez Matas, Jose Felix
AU - Dubini, Gabriele
AU - Boodt, Nikki
AU - Gijsen, Frank J. H.
AU - van der Lugt, Aad
AU - Fereidoonnezhad, Behrooz
AU - Moerman, Kevin M.
AU - McGarry, Patrick
AU - Konduri, Praneeta R.
AU - Arrarte Terreros, Nerea
AU - Marquering, Henk A.
AU - Majoie, Charles B. L. M.
AU - Migliavacca, Francesco
N1 - Funding Information: This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 777072 and N. Arrarte Terreros also received funding from the AMC medical Research BV, Amsterdam UMC, location AMC, under project No 21937. Funding Information: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [HAM reports co-founder and shareholder of Nico.lab, a company that focuses on the use of artificial intelligence for medical image analysis. CBLMM received funds from the European Commission (related to this project, paid to institution); and from CVON/Dutch Heart Foundation, Stryker, TWIN Foundation, Health Evaluation Program Netherlands (unrelated; all paid to institution). CBLMM is shareholder of Nico.lab, a company that focuses on the use of artificial intelligence for medical imaging analysis] Publisher Copyright: © 2021 Elsevier Ltd
PY - 2021/9/20
Y1 - 2021/9/20
N2 - Treatment of acute ischemic stroke has been recently improved with the introduction of endovascular mechanical thrombectomy, a minimally invasive procedure able to remove a clot using aspiration devices and/or stent-retrievers. Despite the promising and encouraging results, improvements to the procedure and to the stent design are the focus of the recent efforts. Computational studies can pave the road to these improvements, providing their ability to describe and accurately reproduce a real procedure. A patient with ischemic stroke due to intracranial large vessel occlusion was selected and after the creation of the cerebral vasculature from computed tomography images and a histologic analysis to determine the clot composition, the entire thrombectomy procedure was virtually replicated. As in the real situation, the computational replica showed that two attempts were necessary to remove the clot, as a result of the position of the stent retriever with respect to the clot. Furthermore, the results indicated that clot fragmentation did not occur as the deformations were mainly in a compressive state without the possibility for clot cracks to propagate. The accurate representation of the procedure can be used as an important step for operative optimization planning and future improvements of stent designs.
AB - Treatment of acute ischemic stroke has been recently improved with the introduction of endovascular mechanical thrombectomy, a minimally invasive procedure able to remove a clot using aspiration devices and/or stent-retrievers. Despite the promising and encouraging results, improvements to the procedure and to the stent design are the focus of the recent efforts. Computational studies can pave the road to these improvements, providing their ability to describe and accurately reproduce a real procedure. A patient with ischemic stroke due to intracranial large vessel occlusion was selected and after the creation of the cerebral vasculature from computed tomography images and a histologic analysis to determine the clot composition, the entire thrombectomy procedure was virtually replicated. As in the real situation, the computational replica showed that two attempts were necessary to remove the clot, as a result of the position of the stent retriever with respect to the clot. Furthermore, the results indicated that clot fragmentation did not occur as the deformations were mainly in a compressive state without the possibility for clot cracks to propagate. The accurate representation of the procedure can be used as an important step for operative optimization planning and future improvements of stent designs.
KW - Acute ischemic stroke
KW - Finite element analysis
KW - INSIST
KW - In silico
KW - Stent-retriever
UR - http://www.scopus.com/inward/record.url?scp=85110575116&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jbiomech.2021.110622
DO - https://doi.org/10.1016/j.jbiomech.2021.110622
M3 - Article
C2 - 34298290
SN - 0021-9290
VL - 126
JO - Journal of Biomechanics
JF - Journal of Biomechanics
M1 - 110622
ER -