Milli-spinner thrombectomy.

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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 disease2-4 by removing clots through aspiration5, stent retriever6 or cutting mechanisms7. However, current mechanical thrombectomy methods fail to remove clots in 10-30% of patients8-10, 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.

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