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Quantitative analysis of periprocedural thrombus fragmentation using an automated optical detection system in a comprehensive stroke intervention training platform
Publikationstyp
Conference Paper
Date Issued
2025-04
Sprache
English
Author(s)
MacMillan, Nadine
Wagner, Maximilian
Article Number
DMD2025-1017, V001T06A005
Citation
Design of Medical Devices Conference, DMD 2025
Contribution to Conference
Publisher DOI
Scopus ID
Publisher
ASME
ISBN
978-0-7918-8873-5
Mechanical thrombectomy for occluded large brain vessels in acute ischemic stroke has proven highly effective, but periprocedural thrombus fragmentation (PTF) remains a significant challenge that can lead to downstream embolization and incomplete recanalization. While laboratory methods exist for detailed PTF analysis, practical solutions are needed for quantitative assessment of simulated thrombectomy procedures performed on physical training models. We present a novel measurement system that enables automated detection and quantification of thrombus fragmentation events during simulated thrombectomy procedures on the HANNES neurointerventional simulator. The system employs a six-channel measurement chamber with integrated UV illumination and an optical detection setup to track fluorescent thrombus fragments. Fragments are automatically detected, assigned IDs, and measured in real-time using computer vision techniques. Validation studies comparing the system's measurements to microscopic analysis demonstrated strong correlation (Pearson's r=0.9939, p<0.001). In controlled testing, the system achieved 100% sensitivity and specificity for single fragment detection, successfully measuring fragments as small as 642 μm in radius. While adhering fragments are currently treated as single entities, the system's ability to automatically track and quantify PTF events in real-time provides an objective basis for evaluating procedural performance and comparing thrombectomy techniques in training scenarios. This novel measurement system represents a practical advance for studying thrombus fragmentation in educational settings. Integration into comprehensive training platforms like HANNES could improve understanding and management of PTF risks, potentially leading to better patient outcomes through enhanced operator training. Future studies correlating PTF metrics with physician experience and clinical results may establish performance benchmarks to help quantify individual proficiency and predict clinical competency.
Subjects
Assessment | HANNES | Neurointervention | Skills | Stroke | Thrombektomy | Thrombi
DDC Class
600: Technology