The role of friction forces in arterial mechanical thrombectomy: a review

IF 2.4 3区医学 Q3 BIOPHYSICS

Journal of biomechanics Pub Date : 2025-09-16 DOI:10.1016/j.jbiomech.2025.112966

Mahesh S. Nagargoje , Virginia Fregona , Giulia Luraghi , Francesco Migliavacca , Guglielmo Pero , Jose Felix Rodriguez Matas

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引用次数: 0

Abstract

Multiple clinical trials have demonstrated the superiority of mechanical thrombectomy (MT) over intravenous thrombolysis (tPA) in treating acute ischemic stroke (AIS). Stent retriever (SR) and aspiration techniques are the standard methods for removing occluded emboli, with evolving technologies improving MT efficiency. However, procedural success remains uncertain. Frictional forces, specifically clot-vessel, clot-SR, and SR-vessel interactions, play a critical role in MT outcomes. This review examines frictional forces during MT and their impact on success, analyzing publications from 2015 to 2025. We focus on studies that calculated friction or retrieval forces using in vitro models. We have also included current trends, limitations, and future perspectives on studying and understanding frictional forces and their implementation into in silico models. Findings indicate that fibrin-rich clots are more difficult to retrieve than red blood cell (RBC)-rich clots due to their higher friction coefficient, three to four times greater, an observation supported by multiple studies. SR-vessel and SR-clot friction also influence MT effectiveness. SR-vessel interaction plays a crucial role in acutely curved vessels, as SR compression reduces its efficiency. In SR-clot interaction, RBC-rich clot fragmentation is linked to relative interaction forces. In summary, obtaining in vivo frictional values remains challenging, and inconsistencies persist in past in vitro studies. Further, a deeper understanding of frictional forces is essential for optimizing MT, improving current SRs, and developing next generation thrombectomy technologies.

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摩擦力在动脉机械取栓中的作用综述。

多项临床试验表明，机械取栓（MT）优于静脉溶栓（tPA）治疗急性缺血性卒中（AIS）。支架回收器（SR）和抽吸技术是去除闭塞栓塞的标准方法，随着技术的发展，MT的效率不断提高。然而，程序上的成功仍然不确定。摩擦力，特别是凝块-血管、凝块- sr和sr -血管的相互作用，在MT结果中起着关键作用。这篇综述考察了MT过程中的摩擦力及其对成功的影响，分析了2015年至2025年的出版物。我们重点研究了使用体外模型计算摩擦或回收力的研究。我们还包括了研究和理解摩擦力及其在硅模型中的实现的当前趋势、局限性和未来观点。研究结果表明，富含纤维蛋白的血块比富含红细胞的血块更难回收，因为它们的摩擦系数更高，是红细胞（RBC）的三到四倍，这一观察结果得到了多项研究的支持。sr血管和sr凝块摩擦也影响MT的有效性。SR-血管相互作用在急性弯曲血管中起着至关重要的作用，因为SR压缩降低了其效率。在sr -凝块相互作用中，富含红细胞的凝块破碎与相对相互作用力有关。总之，获得体内摩擦值仍然具有挑战性，并且在过去的体外研究中持续存在不一致性。此外，更深入地了解摩擦力对于优化MT、改善当前的SRs和开发下一代取栓技术至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of biomechanics 生物-工程：生物医学

CiteScore

5.10

自引率

4.20%

发文量

345

审稿时长

1 months

期刊介绍： The Journal of Biomechanics publishes reports of original and substantial findings using the principles of mechanics to explore biological problems. Analytical, as well as experimental papers may be submitted, and the journal accepts original articles, surveys and perspective articles (usually by Editorial invitation only), book reviews and letters to the Editor. The criteria for acceptance of manuscripts include excellence, novelty, significance, clarity, conciseness and interest to the readership. Papers published in the journal may cover a wide range of topics in biomechanics, including, but not limited to: -Fundamental Topics - Biomechanics of the musculoskeletal, cardiovascular, and respiratory systems, mechanics of hard and soft tissues, biofluid mechanics, mechanics of prostheses and implant-tissue interfaces, mechanics of cells. -Cardiovascular and Respiratory Biomechanics - Mechanics of blood-flow, air-flow, mechanics of the soft tissues, flow-tissue or flow-prosthesis interactions. -Cell Biomechanics - Biomechanic analyses of cells, membranes and sub-cellular structures; the relationship of the mechanical environment to cell and tissue response. -Dental Biomechanics - Design and analysis of dental tissues and prostheses, mechanics of chewing. -Functional Tissue Engineering - The role of biomechanical factors in engineered tissue replacements and regenerative medicine. -Injury Biomechanics - Mechanics of impact and trauma, dynamics of man-machine interaction. -Molecular Biomechanics - Mechanical analyses of biomolecules. -Orthopedic Biomechanics - Mechanics of fracture and fracture fixation, mechanics of implants and implant fixation, mechanics of bones and joints, wear of natural and artificial joints. -Rehabilitation Biomechanics - Analyses of gait, mechanics of prosthetics and orthotics. -Sports Biomechanics - Mechanical analyses of sports performance.