E-077 Laboratory analogs of challenging thromboemboli in acute ischemic stroke

• DOI: 10.1136/neurintsurg-2017-snis.149
• Publication Date: 2017-08-04T19:35:19Z
• Authors: J Chueh; J Litchman; R Arslanian; S Carniato; D Rex; M Howk; M Gounis; A Puri
• Keywords: Stroke

<h3>Introduction</h3> Recent meta-analysis of randomized clinical trials has shown that endovascular intervention yields higher rates revascularization and superior functional outcomes as compared to standard medical therapy in the setting emergent large vessel occlusion causing stroke. However, there remained approximately 20% patients whom successful (mTICI score, 2b or 3) was not achieved after stent-retriever thrombectomy [1, 2]. Revascularization with devices depends part upon integration thrombus material into retrieval device. The histologic composition mechanical properties thrombi are key determinants effective thrombus-device interaction. We hypothesize calcified fibrin-rich stiffer than erythrocyte-rich thrombi; therefore, they may serve challenging models evaluate interactions, further aid design development future generations stent retrievers. goal this study is 1) characterization thromboemboli retrieved from AIS, 2) analogs characteristics similar those for device testing. <h3>Materials methods</h3> Thrombi were AIS using retriever devices. Several technical metrics procedure such number pass attempts occurrence embolic complication collected. Fifty collected twenty nine underwent analysis, subjected dynamic analysis (DMA). Thrombus histology determined by staining specimens erythrocytes fibrin content Martius Scarlet Blue technique performing computerized segmentation quantitative analysis. During DMA tests, stiffness defined a function stress variation over strain. average at low strain (E1: 0 75% strain) high (E2: 75 100% recorded. results generated samples used determine components analogs, calcium apatite-rich analogs. <h3>Results</h3> Of cases analyzed, fifteen required multiple attempts. obtained more 1 26% erythrocyte, 54% fibrin, mixed, whereas all fifty analyzed 33% 47% mixed. demonstrated 0.00011±0.000076MPa, E2: 0.015±0.0083MPa) 0.00013±0.000002MPa, 0.011±0.0007MPa). Compared addition apatite increased 5 times. <h3>Conclusion</h3> successfully developed. analog found be analog. <h3>References</h3> . Saver JL et al: Stent-retriever intravenous t-PA vs. alone N Engl J Med 2015, 372(24):2285–2295. Dorn F Endovascular treatment acute intracerebral artery occlusions solitaire stent: single-centre experience 108 recanalization procedures. Cerebrovasc Dis 2012, 34(1):70–77. <h3>Disclosures:</h3> <b>J. Chueh:</b> None. Litchman:</b> <b>R. Arslanian:</b> <b>S. Carniato:</b> 5; C; Principal Preclinical Research Associate Stryker Neurovascular. <b>D. Rex:</b> <b>M. Howk:</b> Gounis:</b> 1; research grant supported 2; consultant <b>A. Puri:</b> suppported