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

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

Cruts, Janneke M. H. (Erasmus MC)
Giezen, Jo-Anne (Student TU Delft)
van Gaalen, Kim (Erasmus MC)
Beurskens, Robert (Erasmus MC)
Ridwan, Yanto (Erasmus MC)
Dijkshoorn, Marcel L. (Erasmus MC)
Boodt, Nikki (Erasmus MC)
Gijsen, F.J.H. (TU Delft Medical Instruments & Bio-Inspired Technology)
Cahalane, R.M.E. (Erasmus MC)

2023

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.

http://resolver.tudelft.nl/uuid:2210d069-7dfc-4ff0-a298-a1e28b479975

https://doi.org/10.1371/journal.pone.0293456

1932-6203

PLoS ONE, 18 (11)

Institutional Repository

journal article

© 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