Engineers and surgeons at Vanderbilt University in Nashville, Tennessee built a prototype of a surgical device to safely remove blood clots from the brain, a risky and difficult procedure. A team led by Vanderbilt neurosurgery professor Kyle Weaver and mechanical engineering professor Robert Webster describe the system in an upcoming issue of the journal IEEE Transactions on Biomedical Engineering.
Weaver, Webster, and collegues designed the system to treat intracerebral hemorrhages, a type of stroke that occurs when a blood vessel bursts in the brain, causing a sudden increase in pressure and damage to brain cells surrounding the blood. Hemorrhagic strokes make up about 12 percent of all strokes, but they have a high mortality rate; some 40 percent of the individuals die within a month, while many survivors suffer serious brain damage.
To Webster, this issue is personal. His father suffered brain hemorrhage, but was one of the lucky survivors to make a full recovery.
The Vanderbilt device requires only a small hole in the skull to insert a needle made of two thin nested tubes, a straight outer tube and a curved inner tube, each less than 0.05 inches (1.27 millimeters) in diameter.The trajectory stem is fitted over the hole in the skull to assure the proper angle for insertion.
The needle is guided by a detailed image of the clot made by a CT scan. The outer tube extends until it reaches the outer surface of the clot. There the inner curved tube penetrates the clot, where a suction pump removes the blood. The robot controls the position of the inner tube inside the clot.
The device developers tested the system on simulated blood clots made with gelatin. These feasibility studies, say the researchers, succeeded in removing up to 92 percent of the clots.
One problem still encountered with the robotic brain surgeon comes after the removal of substantial portions of the clot, when external pressure collapses some of the outer edges around the clot, making it difficult to keep track of its outer boundaries. The team plans to add ultrasound imaging with a computer model of the brain tissue’s deformity to ensure the clot material, and not surrounding brain tissue, is removed.
In the following video, Weaver, Webster, and graduate student Philip Swaney describe and demonstrate the device.
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