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Workflow level release of microplastics, nanoplastics, and perfluoroalkyl and polyfluoroalkyl substances during simulated neurovascular interventions
Summary
A lab study found that catheters and devices used to treat brain blood clots and aneurysms can shed tiny plastic particles and "forever chemicals" (PFAS) into fluids during the procedure. This suggests patients may be exposed to these contaminants during treatment, highlighting a need for further safety testing of medical device materials.
BACKGROUND: Catheter based neurovascular interventions rely on polymer based, coated, and fluorinated devices. Mechanical manipulation may release particulate and molecular contaminants, but integrated workflow level quantification of microplastic (MP), nanoplastic (NP), and perfluoroalkyl and polyfluoroalkyl substance (PFAS) release during neurovascular procedures remains limited. This study quantified MP, NP, and PFAS release in an in vitro simulation of neurointerventional workflows. METHODS: 20 neurovascular procedures were simulated under standardized in vitro conditions, including 10 mechanical thrombectomy and 10 aneurysm treatment workflows. Procedures were performed in 5 L glass containers using warmed saline, contrast medium, and clinically applied neurovascular devices. Procedural fluid was collected after each simulation and aliquoted for MP, NP, and PFAS analysis using micro-Fourier transform infrared spectroscopy, pyrolysis-gas chromatography-mass spectrometry, and ultra high performance liquid chromatography-tandem mass spectrometry, respectively. RESULTS: Contaminants were detected across all simulated procedures. Median MP particle count was 15 particles per analyzed sample volume (IQR 9.0-27.3; range 0-58), median NP concentration was 18.19 µg/L (IQR 5.85-33.35; range 2.19-1671.10), and median sum PFAS concentration was 127 µg/L (IQR 93.5-272.0; range 47-458). MP and NP levels did not differ between thrombectomy and aneurysm simulations. Sum PFAS concentrations were higher during thrombectomy than during aneurysm treatment simulations (median 209.5 vs 98.0 µg/L; P=0.010), particularly in stent retriever compared with direct aspiration simulations (median 287.0 vs 120.0 µg/L; P=0.030). NP and sum PFAS concentrations were strongly correlated (ρ=0.689; P=0.001). CONCLUSIONS: Simulated neurovascular interventions generated measurable release of MP, NP, and PFAS into procedural fluid. Workflow level assessment may support future source specific testing, clinical validation, and material safety evaluation.