Neuravi Thromboembolic Initiative

The complex nature of a clot can complicate therapeutic intervention. No two occlusions are alike – clots that cause a stroke can have a variety of compositions and properties. The Neuravi Thromboembolic Initiative (NTI) is Neuravi’s commitment to advance the treatment of stroke through interdisciplinary collaboration and investment in clot and occlusion research. 

NTI image

Clot Characterization

Modeling Diverse Clots that Cause Stroke

Clots that cause stroke can come from numerous sources in the body, and they differ in composition, age, and morphology. Neuravi has developed methods to create a wide range of clot analogs that reflect clinical clots, in order to better understand these challenges in treating ischemic stroke.
 

Clot 1

Fresh thrombus encapsulating mature fibrin core
 

clot 2

Young erythrocyte-rich clot analogue
 

clot 3

Partially matured clot analogue

 

clot 4

Heterogeneous clot with erythrocyte-rich and fibrin rich regions

clot 5

Layered clot with mature fibrin base and fresh erythrocyte deposition
 

clot 6

Composite clot with calcific inclusion
 

clot 7

Highly organized fibrin-rich clot analogue

clot 8

Fresh, erythrocyte-rich clot analogue
 

clot 9

Shear-induced fibrin-rich prosthetic valve clot analogue
 

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Staining of four different clot types (x20 magnification). MSB stained fibrin red and erythrocytes yellow:

 

H&E (hematoxylin and eosin staining)
 

 H&E (hematoxylin and eosin staining)


MSB (martius scarlet blue staining)​​
 

MSB (martius scarlet blue staining)

 

STAIN 5

Clot replete with red blood cells (RBCs)
 

STAIN 6

Thrombin induced clot predominately composed of RBCs with interspersed bands of fibrin
 

STAIN 7

Dynamically formed clot, demonstrating a predominance of fibrin with collections of RBCs
 

STAIN 8

Fibrin rich clot, showing delicate fine fibrin strands
 

 

Duffy S, et al. J NeuroIntervent Surg 2016;0:1–7.

Occlusion Dynamics

Advancing the Understanding of Occlusion Dynamics Occlusion formation is influenced by many variables, including clot type, clot geometry, vessel anatomy and flow conditions. Understanding the mechanisms of occlusion formation can provide insights into optimal clot removal technique. A couple of examples of the many occlusions modeled and studied by Neuravi are shown below.

Friction Mechanism
Friction Mechanism

Advancing the Understanding of Occlusion Dynamics Occlusion formation is influenced by many variables, including clot type, clot geometry, vessel anatomy and flow conditions. Understanding the mechanisms of occlusion formation can provide insights into optimal clot removal technique. A couple of examples of the many occlusions modeled and studied by Neuravi are shown below.

00:11
Extrusion Mechanism
Extrusion Mechanism
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Folding Mechanism
Folding Mechanism
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Clot-Device Interaction

Advancing the Understanding of Clot-Device Interaction

Multiple clot properties change with clot-device interaction. One example is that as a clot undergoes compression, the coefficient of friction and resistance to retrieval increases.

Clot Compression Increases Resistance

Compression Clot Graphic

NTI research collaborations are exploring an extensive set of properties and implications related to clot-device interaction.

Education Grant Support

For assistance with the submission of Educational Grant requests: https://www.totalitygrants.com/site/165W/BWI/MDD

References

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