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Hydrodynamics in Acute Ischemic Stroke Catheters Under Static and Cyclic Aspiration Conditions

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Abstract

Purpose

Previous studies have suggested improved recanalization efficiency by using cyclic aspiration as opposed to static aspiration for mechanical thrombectomy in the treatment of acute ischemic stroke (AIS). However, there has not been an investigation into which parameters optimize this theoretical approach. Therefore, this study was designed to investigate the application of static and cyclic pressure in AIS aspiration catheters.

Methods

An experimental flow system was designed to apply and measure both static and cyclic aspiration pressures in four commercial aspiration catheters. A medical aspirator and solenoid-valve were used to generate a range of applied pump pressures and cyclic valve frequencies. The measured mean and oscillatory pressure amplitudes were analyzed and compared across catheters and operating conditions.

Results

The greatest mean pressures and forces were achieved under contact-aspiration conditions using the largest diameter catheter, while the largest oscillating pressure (ΔP) and force (ΔF) values were generated in the least compliant catheter, determined to be proportional to both its inner radius and wall thickness. Furthermore, lower frequency cyclic aspiration was able to generate the largest values of ΔP and ΔF.

Conclusion

For future investigations of cyclic aspiration AIS therapy, the best options are to use large inner diameter and low compliance catheters operating at lower cyclic frequencies to generate the greatest mean and oscillating forces on lodged thromboemboli.

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Authors’ contributions

Dr. Bryan Good performed all of the experimental work, data analysis, and writing of the manuscript. Dr. Francesco Costanzo, Dr. Scott Simon, and Dr. Keefe Manning all served as Dr. Good’s postdoctoral advisors and provided guidance on the project and helped in editing and approving the manuscript submission. Dr. Simon also provided the commercial aspiration catheters used in the experiments and Dr. Manning provided additional funding to purchase research equipment for the experiments.

Data availability

The data that support the findings of this study are available from the corresponding author, KBM, upon reasonable request.

Funding

This study was funded by American Heart Association Postdoctoral Fellowship 19POST34370040.

Conflicts of interest

The authors declare that they have no conflict of interest.

Human Studies/Informed Consent

No human studies were carried out by the authors for this article.

Animal Studies

No animal studies were carried out by the authors for this article.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, Pennsylvania State University, 530 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA

    Bryan C. Good, Francesco Costanzo & Keefe B. Manning

  2. Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA, USA

    Francesco Costanzo

  3. Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA

    Scott D. Simon

  4. Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA

    Keefe B. Manning

Authors
  1. Bryan C. Good
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  2. Francesco Costanzo
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  4. Keefe B. Manning
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Corresponding author

Correspondence to Keefe B. Manning.

Additional information

Associate Editor Matthew J. Gounis oversaw the review of this article.

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Good, B.C., Costanzo, F., Simon, S.D. et al. Hydrodynamics in Acute Ischemic Stroke Catheters Under Static and Cyclic Aspiration Conditions. Cardiovasc Eng Tech 11, 689–698 (2020). https://doi.org/10.1007/s13239-020-00503-w

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  • DOI: https://doi.org/10.1007/s13239-020-00503-w

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