Date of Award
Master of Science (MS)
Venous thromboembolism (VTE) is a vascular disease in which a blood clot forms inside of a vein, most often deep in the legs, groin, or arm. Two types of VTE exist, deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT occurs when a clot in a deep vein forms, risking embolism and causing swelling as the clot obstructs blood ﬂow. An embolism occurs when a part or all the thrombus breaks off and travels in the circulation, getting lodged in the lungs. A pulmonary embolism is a very serious medical condition and can be fatal if not treated immediately. Current guidelines for treatment recommend oral administration of blood thinners, but in cases where alternative measures are needed, intervention with catheter directed thrombolysis (CDT) is commonly attempted. Methods for catheter directed thrombolysis vary greatly, but a regular feature is the option for mechanical agitation. The most commonly seen mechanic for mechanical agitation involves an expanding mesh geometry that is expanded either behind or within the thrombus. The issue with mesh geometries lies in the delicate cell lining of the vessel. Any injury to the vessel lining can cause the recurrence of a VTE as a post treatment complication. Mesh geometries risk breakage, and the expanding radial size can risk contact with the vessel lining. To overcome this disadvantage, we present a novel design for mechanical agitation in catheter directed thrombolysis. In this novel method, a rail mounted ﬁn geometry that is constrained to the centerline is advanced and retracted through a sample thrombus to break up the thrombus and restore ﬂow through the vessel. To this end to study this geometry performance, three performance objectives were outlined. The objectives were peak penetration force, average forward movement force, and average mass of sample removed. 3D printed geometries varying in two angles were tested on porcine thrombus samples for the three objectives. Results suggest that the angle of pitch relative to the front face of the geometry, is very impactful on penetration and forward movement.
Guy Genin, Mohamed Zayed
Guy Genin Mohamed Zayed Jessica Wagenseil