{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T11:31:28Z","timestamp":1794396688401,"version":"4.9.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Endovascular removal of emboli causing large vessel occlusion (LVO)\u2013related stroke utilizing suction catheter and\/or stent retriever technologies or thrombectomy is a new standard of care. Despite high recanalization rates, 40% of stroke patients still experience poor neurological outcomes as many cases cannot be fully reopened after the first attempt. The development of new endovascular technologies and techniques for mechanical thrombectomy requires more sophisticated testing platforms that overcome the limitations of phantom-based simulators. The authors investigated the use of a hybrid platform for LVO stroke constructed with cadaveric human brains.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A test bed for embolic occlusion of cerebrovascular arteries and mechanical thrombectomy was developed with cadaveric human brains, a customized hydraulic system to generate physiological flow rate and pressure, and three types of embolus analogs (elastic, stiff, and fragment-prone) engineered to match mechanically and phenotypically the emboli causing LVO strokes. LVO cases were replicated in the anterior and posterior circulation, and thrombectomy was attempted using suction catheters and\/or stent retrievers.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The test bed allowed radiation-free visualization of thrombectomy for LVO stroke in real cerebrovascular anatomy and flow conditions by transmural visualization of the intraluminal elements and procedures. The authors were able to successfully replicate 105 LVO cases with 184 passes in 12 brains (51 LVO cases and 82 passes in the anterior circulation, and 54 LVO cases and 102 passes in the posterior circulation). Observed recanalization rates in this model were graded using a Recanalization in LVO (RELVO) scale analogous to other measures of recanalization outcomes in clinical use.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The human brain platform introduced and validated here enables the analysis of artery-embolus-device interaction under physiological hemodynamic conditions within the unmodified complexity of the cerebral vasculature inside the human brain.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.7.jns202278","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T03:00:38Z","timestamp":1611284438000},"page":"1072-1080","source":"Crossref","is-referenced-by-count":11,"title":["A human brain test bed for research in large vessel occlusion stroke"],"prefix":"10.3171","volume":"135","author":[{"given":"Daniel","family":"Gebrezgiabhier","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"},{"name":"UC Berkeley\u2013UCSF Graduate Program in Bioengineering, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan;"},{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adithya S.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan;"},{"name":"Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya S.","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis E.","family":"Savastano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"},{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1-2","key":"b1","series-title":"Intervent Neurol","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1159\/000438774","article-title":"Mechanical thrombectomy is now the gold standard for acute ischemic stroke: implications for routine clinical practice","volume":"4","author":"Palaniswami M","year":"2015","unstructured":"Palaniswami M, Yan B. Mechanical thrombectomy is now the gold standard for acute ischemic stroke: implications for routine clinical practice. Intervent Neurol. 2015;4(1-2):18\u201329.10.1159\/000438774"},{"issue":"2","key":"b2","series-title":"J Neurointerv Surg","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1136\/neurintsurg-2015-012218","article-title":"Time to redefine success? TICI 3 versus TICI 2b recanalization in middle cerebral artery occlusion treated with thrombectomy","volume":"9","author":"Kleine JF","year":"2017","unstructured":"Kleine JF, Wunderlich S, Zimmer C, Kaesmacher J. Time to redefine success? TICI 3 versus TICI 2b recanalization in middle cerebral artery occlusion treated with thrombectomy. 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