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Improving Treatment of Ischemic Stroke Using Virtual Thrombectomy

Periodic Reporting for period 1 - VThrombectomy (Improving Treatment of Ischemic Stroke Using Virtual Thrombectomy)

Berichtszeitraum: 2024-01-16 bis 2026-01-15

Acute ischemic stroke is a major cause of mortality and long-term disability worldwide. Mechanical thrombectomy has significantly improved patient outcomes; however, its success remains highly variable, particularly in tortuous cerebral anatomies and for clots with differing mechanical properties. Current clinical practice lacks quantitative tools to predict thrombectomy performance and relies largely on physician experience.

The objective of the VThrombectomy project was to develop and validate a virtual thrombectomy framework that integrates advanced computational modeling with in vitro experimentation. The project aimed to identify and quantify the biomechanical factors—such as clot composition, frictional interactions, vessel flexibility, and device mechanics—that govern thrombectomy success and failure. By doing so, the project sought to provide mechanistic insights that can support device design, procedural optimization, and future in silico clinical trials.
During the fellowship, a physiologically representative virtual thrombectomy framework was developed using finite element methods and validated against in vitro experiments. The work focused on three key areas: (i) modeling clot–device–vessel interactions during mechanical thrombectomy, (ii) investigating catheter navigation through flexible and tortuous cerebral vessels using clinically realistic pushing mechanics, and (iii) experimentally evaluating aspiration thrombectomy performance in curved vessel anatomies with varying clot compositions.

Major achievements include the successful implementation of realistic catheter navigation mechanics, systematic sensitivity analyses of frictional interactions, and validation of computational predictions through controlled in vitro experiments. The project resulted in multiple peer-reviewed publications and manuscripts under review, demonstrating the robustness and relevance of the developed framework.
The project goes beyond the state of the art by introducing a validated, physics-based framework that captures clinically realistic thrombectomy mechanics. Unlike prior studies relying on simplified assumptions, this work demonstrates the critical role of friction coefficients, vessel flexibility, and device–vessel interactions in determining thrombectomy outcomes.

Novel findings include the identification of friction-driven failure mechanisms, stent retriever compression in curved regions, and the influence of catheter tip geometry on aspiration efficiency. The combined in silico–in vitro approach provides predictive capabilities that were previously unavailable and establishes a new benchmark for virtual testing of thrombectomy devices.
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