"Thrombolysis in Coronary Microvascular Obstruction"
Dominik Obrist
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
Coronary microvascular obstruction (MVO) is an injury of the myocardial microcirculation. It typically follows successful recanalization of the blocked coronary artery (primary occlusion) in myocardial infarction. MVO leads to under-perfusion of the affected tissue and negatively impacts patient outcome. Next to other occluding factors, MVO may be caused by microthrombi (debris from the primary occlusion) embolizing vessels of less than 200µm diameter.
It is our goal to improve the diagnosis and treatment of MVO in an emergency clinical setting. To this end, a larger academic consortium has collaborated with a start-up company to develop a catheter-based device for MVO diagnosis and treatment. We will present the results of this interdisciplinary effort. This includes results on the distribution of the microthrombi in the vascular tree and a characterization of their effect on perfusion. The reduced perfusion also limits the delivery of thrombolytic drugs toward the embolizing microthrombi. We will study the efficiency of thrombolysis in a microfluidic chip for different infusion protocols of available thrombolytic drugs and show that microthrombi can be resolved after a primary incubation time of 90 seconds at high drug concentration over 20 minutes.