The association between human blood clot analogue computed tomography imaging, composition, contraction, and mechanical characteristics

Journal article (2023)

Authors

Kim van Gaalen Erasmus MC
K. van Gaalen Erasmus MC
Robert Beurskens Erasmus MC
Robert Beurskens Erasmus MC
Yanto Ridwan Erasmus MC
Nikki Boodt Erasmus MC
Frank Gijsen Medical Instruments & Bio-Inspired Technology - Mechanical, Maritime and Materials Engineering
F. J.H. Gijsen Medical Instruments & Bio-Inspired Technology - Mechanical, Maritime and Materials Engineering
Frank J.H. Gijsen Medical Instruments & Bio-Inspired Technology - Mechanical, Maritime and Materials Engineering
F.J.H. Gijsen Medical Instruments & Bio-Inspired Technology - Mechanical, Maritime and Materials Engineering
R.M.E. Cahalane Erasmus MC
Rachel Cahalane Erasmus MC
More Authors... External organisation
Research Group
Medical Instruments & Bio-Inspired Technology (Mechanical, Maritime and Materials Engineering) (TU Delft)
Copyright: © 2023 Janneke M. H. Cruts, Jo-Anne Giezen, Kim van Gaalen, Robert Beurskens, Yanto Ridwan, Marcel L. Dijkshoorn, Nikki Boodt, F.J.H. Gijsen, R.M.E. Cahalane, More Authors
DOI: https://doi.org/10.1371/journal.pone.0293456
More Info
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Published Date

2023

Language

English

Faculty

Mechanical, Maritime and Materials Engineering

Department

Biomechanical Engineering

Research Group

Medical Instruments & Bio-Inspired Technology

Abstract

Background
Clot composition, contraction, and mechanical properties are likely determinants of endovascular thrombectomy success. A pre-interventional estimation of these properties is hypothesized to aid in selecting the most suitable treatment for different types of thrombi. Here we determined the association between the aforementioned properties and computed tomography (CT) characteristics using human blood clot analogues.

Methods
Clot analogues were prepared from the blood of 4 healthy human donors with 5 red blood cell (RBC) volume suspensions: 0%, 20%, 40%, 60% and 80% RBCs. Contraction was measured as the weight of the contracted clots as a percentage of the original suspension. The clots were imaged using CT with and without contrast to quantify clot density and density increase. Unconfined compression was performed to determine the high strain compressive stiffness. The RBC content was analysed using H&E staining.

Results
The 5 RBC suspensions formed only two groups of clots, fibrin-rich (0% RBCs) and RBC-rich (>90% RBCs), as determined by histology. The density of the fibrin-rich clots was significantly lower (31-38HU) compared to the RBC-rich clots (72-89HU), and the density increase of the fibrin-rich clots was significantly higher (82-127HU) compared to the RBC-rich clots (3-17HU). The compressive stiffness of the fibrin-rich clots was higher (178–1624 kPa) than the stiffness of the RBC-rich clots (6–526 kPa). Additionally, the degree of clot contraction was higher for the fibrin-rich clots (89–96%) compared to the RBC-rich clots (11–77%).

Conclusions
CT imaging clearly reflects clot RBC content and seems to be related to the clot contraction and stiffness. CT imaging might be a useful tool in predicting the thrombus characteristics. However, future studies should confirm these findings by analysing clots with intermediate RBC and platelet content.