Wireless mechanical and hybrid thrombus fragmentation of ex vivo endovascular thrombosis model in the iliac artery

This study investigates the efficacy of an untethered magnetic robot (UMR) for wireless mechanical and hybrid blood clot removal in ex vivo tissue environments. By integrating x-ray-guided wireless manipulation with UMRs, we aim to address challenges associated with precise and controlled blood clot intervention. The untethered nature and size of these robots enhance maneuverability and accessibility within complex vascular networks, potentially improving clot removal efficiency. We explore mechanical fragmentation, chemical lysis, and hybrid dissolution techniques that combine mechanical fragmentation with chemical lysis, highlighting their potential for targeted and efficient blood clot removal. Through experimental validation using an ex vivo endovascular thrombosis model within the iliac artery of a sheep, we demonstrate direct revascularization of a 13-mm-long, 1-day-old blood clot positioned inside the left common iliac artery. This was achieved by deploying a UMR into the abdominal aorta within 15 min. Additionally, both mechanical fragmentation and hybrid dissolution achieve a greater volume rate of change compared to no intervention (control) and chemical lysis alone. Mechanical fragmentation exhibits clot removal with a median of 0.87 mm³/min and a range of 2.81 mm³/min, while the hybrid approach demonstrates slower but more consistent clot removal, with a median of 0.45 mm³/min and a range of 0.23 mm³/min.