Improving Treatment of Stroke: Guiding Endovascular Mechanical Thrombectomy

改善中风治疗：指导血管内机械血栓切除术

• 批准号: 10546005
• 负责人: JOHN B WEAVER
• 金额: $ 28.76万
• 依托单位: LCD NANOTECH LLC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10546005
• 关键词: 3D Print; Acute; Address; Antibodies; Arteries; Back; Binding; Brain; Brain Injuries; Caliber; Carotid Arteries; Catheters; Cessation of life; Coagulation Process; Coronary artery; Distal; Drops; Effectiveness; Elements; Embolism; Excision; Feedback; Fibrin; Friction; Geometry; Hour; Image; Ischemic Stroke; Left; Life; Magnetic nanoparticles; Magnetism; Measures; Mechanics; Methods; Monitor; Motion; Movement; Nanotechnology; Neurologic; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Physicians; Positioning Attribute; Procedures; Process; Refractory; Retrieval; Severities; Signal Transduction; Speed; Stents; Stroke; Surface; Symptoms; Techniques; Therapeutic Embolization; Thrombectomy; Thrombosis; Thrombus; Time; Traction; United States; X-Ray Medical Imaging; cerebral artery; contrast enhanced computed tomography; disability; improved; improved outcome; intravenous administration; magnetic field; nanoGold; nanoparticle; risk minimization; stent thrombus; stroke therapy; tool; 3D Print; Acute; Address; Antibodies; Arteries; Back; Binding; Brain; Brain Injuries; Caliber; Carotid Arteries; Catheters; Cessation of life; Coagulation Process; Coronary artery; Distal; Drops; Effectiveness; Elements; Embolism; Excision; Feedback; Fibrin; Friction; Geometry; Hour; Image; Ischemic Stroke; Left; Life; Magnetic nanoparticles; Magnetism; Measures; Mechanics; Methods; Monitor; Motion; Movement; Nanotechnology; Neurologic; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Physicians; Positioning Attribute; Procedures; Process; Refractory; Retrieval; Severities; Signal Transduction; Speed; Stents; Stroke; Surface; Symptoms; Techniques; Therapeutic Embolization; Thrombectomy; Thrombosis; Thrombus; Time; Traction; United States; X-Ray Medical Imaging; cerebral artery; contrast enhanced computed tomography; disability; improved; improved outcome; intravenous administration; magnetic field; nanoGold; nanoparticle; risk minimization; stent thrombus; stroke therapy; tool

Abstract: In the last few years there has been a revolution in the treatment of ischemic stroke. Thrombus dissolving drugs help many patients but have limited effectiveness when the large cerebral arteries are blocked. It has recently been shown that physically removing the thrombus through a catheter is remarkably effective at reducing the damage to the brain. Removing the thrombus can be effective up to 24 hours after the onset of symptoms. The retrieval method that is most consistently effective is to engage the thrombus with a stent-like retriever and use the retriever to pull the thrombus back into a catheter. One of the challenging aspects of removing the thrombus with this method is that the thrombus cannot be directly visualized during the process of retrieval. The thrombus can be left behind as the stent is pulled back, or fragments of the thrombus can break off and lodge downstream where they cannot be reached. The thrombus itself cannot be seen in x-ray images so there is no way to know how completely the thrombus is being moved with the stent-retriever. We propose to develop unique magnetic nanotechnology to monitor mechanical extraction of these thromboses. The thrombus will be coated with magnetic nanoparticles and the signal from those nanoparticles will be used to monitor the position of the thrombus relative to the stent-retriever. Using the stent-retriever itself as an antenna, one can measure signal from nearby magnetic nanoparticles bound within the thrombus. We will demonstrate that the signal changes dramatically if the thrombus moves relative to the stent-retriever or if a fragment breaks off the thrombus. We will also demonstrate that it is possible to produce images of the thrombus during thrombus removal. These tools will enable the physician to reduce procedure time, more consistently remove the entire thrombus which we expect will improve patient outcomes.

摘要：在过去的几年中，缺血性中风的治疗发生了一场革命。血栓 溶解药物可以帮助许多患者，但是当大脑大动脉被阻塞时，有效性有限。 最近已经显示，通过导管物理去除血栓，在 减少对大脑的损害。卸下血栓可以在开始后24小时生效 症状。 最有效的检索方法是与支架般的猎犬接合血栓 并用猎犬将血栓拉回导管中。删除挑战的方面之一 使用此方法的血栓是，在检索过程中不能直接对血栓进行可视化。这 当支架向后拉时，血栓可能会留在后面，或者血栓的碎片可以折断并寄养 下游无法到达它们。血栓本身在X射线图像中无法看到，因此没有 知道通过支架重新放置的血栓被移动的方式。 我们建议开发独特的磁性纳米技术来监测这些的机械提取 血栓形成。血栓将用磁性纳米颗粒和来自这些纳米颗粒的信号涂覆 将用于监视血栓相对于支架重新晶体的位置。使用支架回程本身 作为天线，可以测量附近磁性纳米颗粒结合的信号。我们将 证明信号如果血栓相对于支架重新分配者或a 碎片破裂了血栓。我们还将证明可以产生血栓的图像 在去除血栓期间。这些工具将使医生能够减少程序时间，更稳定 删除我们期望可以改善患者预后的整个血栓。