Clot treatment via spinning-induced fibrin microstructure densification and clot volume reduction

Abstract

Blood clots, composed of red blood cells (RBCs) embedded within a fibrin network, can cause life-threatening conditions such as strokes and heart attacks. However, conventional thrombectomy techniques, such as aspiration or stent retrievers, often struggle with large or tough clots, limiting their clinical efficacy. The recently developed milli-spinner thrombectomy offers a breakthrough approach that fundamentally departs from these traditional methods. Instead of extracting the clot intact, the milli-spinner mechanically shrinks the clot by densifying its microstructure through the combined action of compression and shear forces, achieving up to 95 % volume reduction. This novel clot debulking strategy enables more effective clot removal and holds strong potential for significantly improved clinical outcomes in thrombectomy procedures. To uncover the underlying mechanisms and optimize performance, we combine in vitro experiments with dissipative particle dynamics (DPD) simulations for multiscale analysis of clot volume reduction and microstructural densification under integrated compression and shear. Experiments quantify macroscopic clot volume reduction under controlled loading, while simulations reveal microscale fibrin network densification and RBC release. This systematic study provides a quantitative understanding of how different loading modes alter clot microstructure across clot types. These findings lay the foundation for the rational design of next-generation thrombectomy systems, capable of mechanically reconfiguring clot microstructure in situ, offering enhanced efficacy and broader clinical applicability.