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Neuro 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 Neuro Thromboembolic Initiative (NTI) is the commitment to advance the treatment of stroke through interdisciplinary collaboration and investment in clot and occlusion research.
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. NTI has developed methods to create a wide range of clot analogues that reflect clinical clots, in order to better understand these challenges in treating ischemic stroke.
Fresh thrombus encapsulating mature fibrin core
Young erythrocyte-rich clot analogue
Partially matured clot analogue
Heterogeneous clot with erythrocyte-rich and fibrin rich regions
Layered clot with mature fibrin base and fresh erythrocyte deposition
Composite clot with calcific inclusion
Highly organised fibrin-rich clot analogue
Fresh, erythrocyte-rich clot analogue
Shear-induced fibrin-rich prosthetic valve clot analogue
Staining of four different clot types (x20 magnification). MSB stained fibrin red and erythrocytes yellow:
Clot replete with red blood cells (RBCs)
Thrombin-induced clot predominately composed of RBCs with interspersed bands of fibrin
Dynamically formed clot, demonstrating a predominance of fibrin with collections of RBCs
Fibrin-rich clot, showing delicate, fine fibrin strands
Duffy S, et al. J NeuroIntervent Surg 2016;0:1–7.
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 techniques. A couple of examples of the many occlusions modeled and studied by NTI are shown below.
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.
NTI research collaborations are exploring an extensive set of properties and implications related to clot-device interaction.
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