Milli-spinner thrombectomy

• 成果类型: Article
• 署名作者: Chang, Yilong; Wu, Shuai; Li, Qi; Pulli, Benjamin; Salmi, Darren; Yock, Paul; Heit, Jeremy J.; Zhao, Ruike Renee
• 署名单位: Stanford University; Stanford University; Stanford University; Stanford University
• 刊物名称: Nature
• ISSN/ISSBN: 0028-2826
• DOI: 10.1038/s41586-025-09049-0
• 发表日期: 2025-06-12
• 关键词: mechanical thrombectomy; ischemic-stroke; distal; RISK

摘要

Clot-induced blockage in arteries or veins can cause severe medical conditions1. Mechanical thrombectomy is a minimally invasive technique used to treat ischaemic stroke, myocardial infarction, pulmonary embolism and peripheral vascular disease2, 3-4 by removing clots through aspiration5, stent retriever6 or cutting mechanisms7. However, current mechanical thrombectomy methods fail to remove clots in 10-30% of patients8, 9-10, especially in the case of large, fibrin-rich clots11. These methods can also rupture and fragment clots12, causing distal emboli and poor outcomes13. To overcome these challenges, we develop the milli-spinner thrombectomy, which uses a simple yet innovative mechanics concept to modify the clot's microstructure, facilitating its removal. The milli-spinner works by mechanically densifying the clot's fibrin network and releasing red blood cells through spinning-induced compression and shear forces. It can shrink the clot volume by 95% for easy and fast removal. In vitro tests in pulmonary and cerebral artery flow models and in vivo experiments in swine models demonstrate that the milli-spinner achieves ultrafast clot debulking and high-fidelity revascularization, outperforming aspiration thrombectomy. The milli-spinner thrombectomy directly modifies the clot microstructure to facilitate clot removal, improving mechanical thrombectomy success rates compared with current methods that rely on clot rupture or cutting. This approach offers a promising new direction for mechanical thrombectomy devices, especially for treating ischaemic stroke, pulmonary embolism and peripheral thrombosis.