<p>Reduction of Cerebral Emboli: In vitro Study with a Novel Cerebral Embolic Protection Device</p>

Abstract

Aim: To assess the efficacy of the TriGUARD 3™, a novel cerebral embolic protection (CEP) device in reducing cerebral embolization by deflecting embolic debris away from the cerebral circulation using a quantitative in vitro model. Methods and Results: This in vitro study assessed the ability of a cerebral embolic protection device to deflect embolic debris, by measuring the percent of particles and air bubbles, 200 µm and 300 µm in size, from entering the cerebral circulation compared to unprotected controls. A 3D printed silicone model of the ascending aorta, the aortic arch with its three major cerebral arteries and the descending aorta was connected to a custom-made simulator that mimics physiological pulsatile flow patterns of the left ventricle. Comparative analyses were used to assess the efficacy of the cerebral embolic protection device to deflect particles and air bubbles away from the major cerebral arteries. The percent of particles and air bubbles entering the major cerebral arteries was significantly lower with cerebral embolic protection compared to unprotected controls (p<0.0001). Cerebral protection resulted in 97.4-100% reduction in air bubble counts, and 97.4-97.8% reduction in particle counts compared to unprotected controls. Conclusion: This in vitro study used simulated physiologic flow conditions in an aortic arch model to demonstrate >97% efficacy of the TriGUARD 3 CEP device, in reducing cerebral embolization of particulate and air bubbles of 200 µm to 300 µm in size.

Brain Protection in the Endo-Management of Proximal Aortic Aneurysms

“…This is keeping with open cardiac surgery whereby the use of oxygenators can lead to cerebral microembolisation and neurocognitive decline [58]. The use of a dynamic bubble trap(HPmedica, Augsburg, Germany) designed to reduce gaseous embolisation has been found to reduce TCD MES with improved cognitive function three months following coronary artery bypass), and the TriGuard 3 CEPD reduced cerebral embolization of particulate and air bubbles under simulated conditions [59]. In the future, technological developments could focus on the design of supra-aortic vessel filters that prevent the passage of both solid and gaseous microemboli during TEVAR.…”