Is 100% survival after stroke achievable?

Newswise — In Tim Becker laboratory, the “patient” lies on a surgical table and a blood clot lurks in a cerebral vessel. It’s a terrifying scenario, similar to stroke, one of the leading causes of death and disability in the United States.

But there’s a catch: The patient isn’t a real person, just a collection of tubes and pumps circulating fluids. And Becker isn’t a surgeon—he’s a mechanical engineer. With his team, Becker aims to develop and test medical devices that can better treat stroke patients in the critical hours after a stroke.

“Stroke is quite a large area of ​​research, and the current treatments are not very good,” said Becker, who leads Bioengineering Devices Laboratory at NAU. “The devices coming out today are evolving very rapidly, and we are on the ground floor of that process.”

He has been working in this space, both in the laboratory and in industry, since the beginning of his career. Now, in addition to innovation, Becker is training the next generation of medical device developers. More than a dozen postgraduate and undergraduate students in bioengineering, biology, physiotherapy, chemistry and materials science are collaborating to develop the devices and systems needed to test them. They graduate with hundreds of hours of hands-on experience, industry collaborations, co-authored journal articles, patents, federal grants and job offers.

It’s an exciting place.

The path to 100% effectiveness in stroke treatment

Becker’s lab is working on medical devices to treat ischemic and hemorrhagic strokes. Ischemic strokes, which are caused by a blood clot in the brain, are treated either by injecting the patient with a clot-dissolving drug or by inserting a catheter that allows doctors to vacuum out the clot. The suction process, developed about a decade ago, is 50 to 60 percent effective—significantly better than the drug, but not nearly enough.

Becker and his students are developing suction devices that can capture the entire clot. Becker likened this procedure to trying to suck the top of a muffin into a tube – with enough suction, some of the muffin will get into the tube and it may be possible to suck it all in. However, luck plays a big role: it is often a bit lacking.

“We’re working on a catheter with a tip that can adapt to the shape of the vessel and catch the entire clot, not just part of it,” Becker said. “Our catheter would open up and catch the entire clot and suck it out on the first pass, rather than allowing pieces to slip down and potentially cause another stroke. That could really increase the effectiveness of treatment.”

A hemorrhagic stroke occurs when an aneurysm in the brain ruptures. Currently, the patient has a 15% chance of survival after a hemorrhagic stroke. Aneurysms, when detected before they rupture, can be treated surgically; a coil is placed into the aneurysm’s mouth to strengthen the weakened vessel. A balloon is inserted into the vessel to hold the coil in place (using an adhesive-like material also developed in Becker’s lab). Problem? The blood vessel is blocked for about 10 minutes, preventing blood from reaching the brain.

Becker’s lab is developing a new balloon mesh that will work like a balloon but will be porous, allowing blood to flow through the vessels as normal and causing the vessel to heal over the entrance to the aneurysm. The team has built three prototypes of this material and plans to create two more.

Testing on simulated patients

The “patient” in Becker’s laboratory was carefully created to mimic a human. The “blood vessels” are 3D printed from a flexible material that responds to blood flow just like human blood vessels. “Blood” is a liquid with a similar mechanical structure to human blood that is moved through vessels using a pump system that can be programmed to mimic the heart of a child or adult, male or female.R woman of different ages. (They jargon program it to to differT ethnic groups-manT.) Everything is connected to a computer that measures heart rate, blood pressure, blood flow and more.

With a biohazard-free environment, Becker and his team can work on prototypes, test what works, what needs to be improved, change variables — through trial and error.

In February, Becker’s team held a four-hour video call with researchers at Harvard Medical School, testing various devices that Harvard had sent them. The doctors found that when they placed the devices in live patients, the patients didn’t respond the way the doctors expected. They wanted to know how to get those results, so Becker held up a camera to his simulated patient and worked with the devices, watching the measurements on a computer screen.

ATTACKING racial and gender disparities in health outcomes

For the last 50 years, medical devices have been manufactured for the average white man. It turns out it doesn’t work – not only because of biological differences between genders and races, but also because the “average white person” is a medical myth. Every person’s body is different and for medical devices to be effective, they must be adapted to different body types.

Holly Bernsa PhD bioengineering student is developing a prototype, called the ATTAC catheter, that is more adaptive—instead of one size, it will be one device that can be adjusted based on size. Having one device that can treat multiple body types is a cost-saving measure for hospitals that will also translate into better outcomes for stroke patients: men currently have a survival rate of about 60%, while women have a survival rate of about 30-45%.

Berns, who received a $500,000 grant from the National Institutes of Health, will graduate in about a year and hopes to take the ATTAC catheter through the development, testing and patent process and then put it into production for the site commercial.

“I joined this lab four years ago and right after that my partner at the time had a stroke,” she said. “Sitting with him in the hospital and knowing his stroke history, it’s just unacceptable that we’re only at 60%. We can do better—we have to do better.”