O-035 Hybrid human brain model for research in large vessel occlusion stroke

• DOI: 10.1136/neurintsurg-2020-snis.35
• Publication Date: 2020-08-06T18:40:49Z
• Authors: L Savastano; Y Liu; D Gebrezgiabhier; D Evan; A Reddy; Y Zheng; A Shih; A Pandey
• Keywords: Embolus; Lumen (anatomy); Penumbra

<h3>Introduction</h3> Cerebral artery phantoms are valuable tools to test recanalization strategies of large vessel occlusion (LVO). However, these artificial models do not mimic the complex angioarchitecture and hemodynamic conditions human cerebrovasculature, embolus/endothelium interaction, nor response delicate arterial walls mechanical forces. In-vivo animal also available; however, such represent geometry, structure, or cerebral arteries. To overcome inadequacies, we present a bed consisting pressurized brains which was developed validated for LVO revascularization. <h3>Materials Methods</h3> Twenty-four fresh were harvested from autopsies. Internal carotid arteries vertebral cannulated with 8F sheaths connected in parallel hydraulic system. Saline solution infused at physiological flow rate pressure adjusted through an escape mechanism. Then, three types representative embolus analogs (EAs) fabricated (elastic, fragment-prone, stiff) using multilinear regression model derived histology characterization tensile properties (including stiffness, ultimate strain stress) sixteen emboli causing strokes. EAs introduced into system brain allowed embolize EA downstream vasculature recreate LVO. attempted 61 cases ADAPT technique employing suction catheter (ACE™ 68; Penumbra) 44 CAPTIVE stent retriever (Solitaire™ Platinum, Medtronic) catheter. Two cameras recorded videos embolization process thrombectomy. Recanalization findings used derive Thrombolysis Infarction (aTICI) as proxy modified TICI scale. <h3>Results</h3> The highly realistic performance direct trans-mural visualization real-time thrombectomy Physiological pulsatile waveforms generated consistently by adjusting valve. appropriately represented spectrum features encountered removed during stroke. optically semi-transparent enabled conventional visualize embolus-device interaction high resolution without radiation. lodged bifurcating points main parent good tolerance physiologic fragmentation migration. observed protrude smaller branches perforating We able successfully replicate 105 (51 anterior circulation, 54 posterior circulation). First pass (45%), successful (71%) complete (60%) rates this proposed aTICI consistent published results mTICI same devices techniques. Direct observation procedure demonstrated that current technologies load forces, where elongate undergo uncontrolled multifocal leading recurrent residual LVO, requiring repeated attempts. <h3>Conclusion</h3> A embolic cerebrovascular different research technology testing. <h3>Disclosures</h3> <b>L. Savastano:</b> None. <b>Y. Liu:</b> <b>D. Gebrezgiabhier:</b> Evan:</b> <b>A. Reddy:</b> Zheng:</b> Shih:</b> Pandey:</b>