Yilong Chang, Shuai Wu, Qi Li, Benjamin Pulli, Darren Salmi, Paul Yock, Jeremy J. Heit, Ruike Renee Zhao
{"title":"Milli-spinner thrombectomy","authors":"Yilong Chang, Shuai Wu, Qi Li, Benjamin Pulli, Darren Salmi, Paul Yock, Jeremy J. Heit, Ruike Renee Zhao","doi":"10.1038/s41586-025-09049-0","DOIUrl":null,"url":null,"abstract":"<p>Clot-induced blockage in arteries or veins can cause severe medical conditions<sup>1</sup>. Mechanical thrombectomy is a minimally invasive technique used to treat ischaemic stroke, myocardial infarction, pulmonary embolism and peripheral vascular disease<sup>2,3,4</sup> by removing clots through aspiration<sup>5</sup>, stent retriever<sup>6</sup> or cutting mechanisms<sup>7</sup>. However, current mechanical thrombectomy methods fail to remove clots in 10–30% of patients<sup>8,9,10</sup>, especially in the case of large, fibrin-rich clots<sup>11</sup>. These methods can also rupture and fragment clots<sup>12</sup>, causing distal emboli and poor outcomes<sup>13</sup>. 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.</p>","PeriodicalId":18787,"journal":{"name":"Nature","volume":"456 1","pages":""},"PeriodicalIF":50.5000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature","FirstCategoryId":"103","ListUrlMain":"https://doi.org/10.1038/s41586-025-09049-0","RegionNum":1,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
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 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.
期刊介绍:
Nature is a prestigious international journal that publishes peer-reviewed research in various scientific and technological fields. The selection of articles is based on criteria such as originality, importance, interdisciplinary relevance, timeliness, accessibility, elegance, and surprising conclusions. In addition to showcasing significant scientific advances, Nature delivers rapid, authoritative, insightful news, and interpretation of current and upcoming trends impacting science, scientists, and the broader public. The journal serves a dual purpose: firstly, to promptly share noteworthy scientific advances and foster discussions among scientists, and secondly, to ensure the swift dissemination of scientific results globally, emphasizing their significance for knowledge, culture, and daily life.