Mechanical Rubbing of Blood Clots Using Helical Robots Under Ultrasound Guidance

摘要

A simple way to mitigate the potential negative side-effects associated with chemical lysis of a blood clot is to tear its fibrin network via mechanical rubbing using a helical robot. Here, we achieve mechanical rubbing of blood clots under ultrasound guidance and using external magnetic actuation. Position of the helical robot is determined using ultrasound feedback and used to control its motion toward the clot, whereas the volume of the clots is estimated simultaneously using visual feedback. We characterize the shear modulus and ultimate shear strength of the blood clots to predict their removal rate during rubbing. Our <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">in vitro</i> experiments show the ability to move the helical robot controllably toward clots using ultrasound feedback with average and maximum errors of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">${\text{0.84}\pm \text{0.41}}$</tex-math></inline-formula> and 2.15 mm, respectively, and achieve removal rate of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$-\text{0.614} \pm \text{0.303}$</tex-math> </inline-formula> mm <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$^{3}$</tex-math></inline-formula> /min at room temperature ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">${\text{25}}^{\circ }$</tex-math></inline-formula> C) and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$-\text{0.482} \pm \text{0.23}$</tex-math></inline-formula> mm <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$^{3}$</tex-math></inline-formula> /min at body temperature (37 <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$^{\circ}$</tex-math></inline-formula> C), under the influence of two rotating dipole fields at frequency of 35 Hz. We also validate the effectiveness of mechanical rubbing by measuring the number of red blood cells and platelets past the clot. Our measurements show that rubbing achieves cell count of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$(\text{46} \pm \text{10.9}) \times \text{10}^{4}$</tex-math> </inline-formula> cell/ml, whereas the count in the absence of rubbing is <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX"> $(\text{2} \pm \text{1.41}) \times \text{10}^{4}$</tex-math></inline-formula> cell/ml, after 40 min.