  Blockage of blood flow in arteries or veins by blood clots can lead to
serious medical conditions. Mechanical thrombectomy (MT), minimally invasive
endovascular procedures that utilize aspiration, stent retriever, or cutting
mechanisms for clot removal have emerged as an effective treatment modality for
ischemic stroke, myocardial infarction, pulmonary embolism, and peripheral
vascular disease. However, state-of-the-art MT technologies still fail to
remove clots in approximately 10% to 30% of patients, especially when treating
large-size clots with high fibrin content. In addition, the working mechanism
of most current MT techniques results in rupturing or cutting of clots which
could lead to clot fragmentation and distal emboli. Here, we report a new MT
technology based on an unprecedented mechanism, in which a milli-spinner
mechanically debulks the clot by densifying its fibrin fiber network and
discharging red blood cells to significantly reduce the clot volume for
complete clot removal. This mechanism is achieved by the spin-induced
compression and shearing of the clot. We demonstrate its effective
clot-debulking performance with clot volumetric reduction of up to 90% on
various sizes of clots with diverse clot compositions. Milli-spinner MT in both
in-vitro pulmonary and cerebral artery flow models and in-vivo swine models
demonstrate high-fidelity revascularization. The milli-spinner MT is the first
reported mechanism that directly modifies the clot microstructure to facilitate
clot removal, which also results in markedly improved MT efficacy compared to
the existing MT mechanisms that are based on clot rupturing and cutting. This
technology introduces a unique mechanical way of debulking and removing clots
for future MT device development, especially for the treatment of ischemic
stroke, pulmonary emboli, and peripheral thrombosis.
