Milli-spinner thrombectomy.

Abstract

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 disease^2-4 by removing clots through aspiration⁵, stent retriever⁶ or cutting mechanisms⁷. However, current mechanical thrombectomy methods fail to remove clots in 10-30% of patients^8-10, 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.