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Eyisoylu H, Hazekamp ED, Cruts J, Koenderink GH, de Maat MPM. Flow affects the structural and mechanical properties of the fibrin network in plasma clots. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:8. [PMID: 38285167 PMCID: PMC10824866 DOI: 10.1007/s10856-024-06775-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024]
Abstract
The fibrin network is one of the main components of thrombi. Altered fibrin network properties are known to influence the development and progression of thrombotic disorders, at least partly through effects on the mechanical stability of fibrin. Most studies investigating the role of fibrin in thrombus properties prepare clots under static conditions, missing the influence of blood flow which is present in vivo. In this study, plasma clots in the presence and absence of flow were prepared inside a Chandler loop. Recitrated plasma from healthy donors were spun at 0 and 30 RPM. The clot structure was characterized using scanning electron microscopy and confocal microscopy and correlated with the stiffness measured by unconfined compression testing. We quantified fibrin fiber density, pore size, and fiber thickness and bulk stiffness at low and high strain values. Clots formed under flow had thinner fibrin fibers, smaller pores, and a denser fibrin network with higher stiffness values compared to clots formed in absence of flow. Our findings indicate that fluid flow is an essential factor to consider when developing physiologically relevant in vitro thrombus models used in researching thrombectomy outcomes or risk of embolization.
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Affiliation(s)
- Hande Eyisoylu
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Bionanoscience, Kavli Institute of Nanoscience, Delft University of Technology, Delft, the Netherlands
| | - Emma D Hazekamp
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Janneke Cruts
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Gijsje H Koenderink
- Department of Bionanoscience, Kavli Institute of Nanoscience, Delft University of Technology, Delft, the Netherlands.
| | - Moniek P M de Maat
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Thony F, Pernes JM, Menez C, Quesada JL, Heautot JF, Thouveny F, Monnin-Bares V, Bellier A, David A, Lablee A, Bouvier A, Vernhet-Kovacsik H, Douane F, Del Giudice C, Sapoval M, Guillen K, Loffroy R, Finas M, Rodiere M. Endovascular Thrombectomy for Acute Iliofemoral Deep Venous Thrombosis Through a Jugular Approach with a Rotational Device. Cardiovasc Intervent Radiol 2023; 46:1684-1693. [PMID: 37596417 DOI: 10.1007/s00270-023-03529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/25/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To report the effectiveness of pharmacomechanical catheter-directed thrombolysis (PCDT) in the management of acute iliofemoral deep venous thrombosis (DVT) via the jugular vein using a slow rotation and large-tip device (SRD) in a large cohort of patients. MATERIAL AND METHODS From 2011 to 2021, 277 patients (mean age 45 years, 59.2% women) were treated in 6 centres with PCDT for ilio-fémoral DVT. PCDT was performed via the jugular vein and consisted of one session of fragmentation-fibrinolysis, aspiration and, if needed, angioplasty with stenting. The aim of PCDT was to achieve complete clearance of the venous thrombosis and to restore iliofemoral patency. Residual thrombotic load was assessed by angiography, venous patency by duplex ultrasound and clinical effectiveness by the rate of post-thrombotic syndrome (Villalta score > 4). RESULTS All patients were treated via the jugular vein using an SRD, and all but one were treated with fibrinolysis. Angioplasty with stenting was performed in 84.1% of patients. After the procedure, the residual thrombotic load at the ilio-fémoral region was < 10% in 96.1% of patients. The rate of major complications was 1.8% (n = 5), the rate of minor complications was 4% (n = 11), and one patient died from pulmonary embolism (0.4%) At a median follow-up of 24 months, primary and secondary iliofemoral patency was 89.6% and 95.8%, respectively. The rate of PTS was 13.8% at 12 months. CONCLUSION PCDT via the jugular vein using an SRD is an efficient treatment for acute iliofemoral DVT and results in high long-term venous patency and low PTS rates. Level of evidence Level 4, Case series.
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Affiliation(s)
- Frederic Thony
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France.
| | - Jean-Marc Pernes
- Cardio-Vascular and Interventional Department, Antony Private Hospital, Antony, France
| | - Caroline Menez
- University Grenoble Alpes, Department of Vascular Medicine, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Quesada
- University Grenoble Alpes, Clinical Investigation Center, CHU Grenoble Alpes, Grenoble, France
| | | | | | - Valerie Monnin-Bares
- Department of Imaging and Interventional Radiology, Montpellier University Hospital, Montpellier, France
| | - Alexandre Bellier
- University Grenoble Alpes, Clinical Investigation Center, CHU Grenoble Alpes, Grenoble, France
| | - Arthur David
- Department of Radiology, Nantes University Hospital, University of Medicine, Nantes, France
| | - Alexandre Lablee
- Radiology Department, University Hospital Pontchaillou, Rennes, France
| | | | - Helene Vernhet-Kovacsik
- Department of Imaging and Interventional Radiology, Montpellier University Hospital, Montpellier, France
| | - Frederic Douane
- Department of Radiology, Nantes University Hospital, University of Medicine, Nantes, France
| | | | - Marc Sapoval
- Vascular and Oncological Interventional Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Kevin Guillen
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, Dijon, France
| | - Romaric Loffroy
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, Dijon, France
| | - Mathieu Finas
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France
| | - Mathieu Rodiere
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France
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