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Basic science
Original research
Suction force rather than aspiration flow correlates with recanalization in hard clots: an in vitro study model
  1. David Fernandez-Sanchez1,
  2. Daniel Garcia-Sabido1,
  3. Tudor G Jovin2,
  4. Helena Villanova1,
  5. Tommy Andersson3,4,
  6. Raul G Nogueira5,
  7. Cristophe Cognard6,
  8. Marc Ribo7,8,
  9. Adnan H Siddiqui9,
  10. Iñaki Galve1,
  11. Ofir Arad1,
  12. François Salmon1
  1. 1 R&D, Anaconda Biomed, S L Barcelona, Spain
  2. 2 Department of Neurointerventional Surgery, Cooper University Health Care, Camden, New Jersey, USA
  3. 3 Departments of Radiology and Neurology, AZ Groeninge, Kortrijk, Belgium
  4. 4 Department of Neuroradiology and Department of Clinical Neuroscience, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
  5. 5 Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
  6. 6 Diagnostic and Therapeutic Neuroradiology, Hôpital Purpan, Toulouse, France
  7. 7 Stroke Unit, Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
  8. 8 Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
  9. 9 Departments of Neurosurgery and Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
  1. Correspondence to Dr Marc Ribo, Stroke Unit. Neurology, Hospital Vall d'Hebron, 08035 Barcelona, Spain; marcriboj{at}hotmail.com

Abstract

Background ANA Advanced Neurovascular Access provides a novel funnel component designed to reduce clot fragmentation and facilitate retrieval in combination with stent-retrievers (SRs) in stroke patients by restricting flow and limiting clot shaving. In previous publications ANA presented excellent in vitro/in vivo efficacy data, especially with fibrin-rich hard clots. We aimed to determine the main physical property responsible for these results, namely suction force versus aspiration flow.

Methods We evaluated in a bench model the suction force and flow generated by ANA and compared them to other neurovascular catheters combined with a SR (Solitaire). Aspiration flow was evaluated with a flow rate sensor while applying vacuum pressure with a pump. Suction force was determined using a tensile strength testing machine and a purposely designed tool that completely seals the device tip simulating complete occlusion by a hard clot. Suction force was defined as the force needed to separate the device from the clot under aspiration. All experiments were repeated five times, and mean values used for comparisons.

Results Aspiration flow increased with the inner diameter of the device: ANA 1.85±0.04 mL/s, ACE68 3.74±0.05 mL/s, and 8F-Flowgate2 5.96±0.30 mL/s (P<0.001). After introducing the SR, the flow was reduced by an average of 0.57±0.12 mL/s. Due to its larger distal surface, ANA suction force (1.69±0.40 N) was significantly higher than ACE68 (0.26±0.04 N) and 8F-Flowgate2 (0.42±0.06 N) (P<0.001). After introducing the SR, suction force variation was not relevant except for ANA that increased to 2.64±0.41 N.

Conclusion Despite lower in vitro aspiration flow, the ANA design showed a substantially higher suction force than other thrombectomy devices.

  • stroke
  • thrombectomy
  • device

Data availability statement

All data are available upon reasonable request to the corresponding author: https://orcid.org/0000-0001-9242-043X

https://doi.org/10.1136/neurintsurg-2020-017242

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    Data availability statement

    All data are available upon reasonable request to the corresponding author: https://orcid.org/0000-0001-9242-043X

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    Footnotes

    • Twitter @marcriboj, @o_arad

    • Contributors DF-S, DG-S, HV, OA, MR, IG and FS conceived the design, performed the experiments, analyzed the data, and drafted the manuscript. RGN, TGJ, TA, CC and AHS made substantial contributions to data interpretation and critical review for intellectual content.

    • Funding This work was supported by Anaconda Biomed.

    • Competing interests DF-S, DG-S, HV, OA, IG and FS are employees of Anaconda Biomed, a company that provided funding for the present study. MR and OA are the Co-Founders of Anaconda Biomed.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.