A mini copy of your carotid artery could help predict stroke risk

A microfluidic device lined with a specific patient's own carotid artery cells and exposed to that patient's own blood flow can watch clot formation in real time. Researchers say the platform may eventually let doctors test which anti-clot strategy works for an individual before prescribing.

The system was published July 23 in Cell Biomaterials by a University of Sydney and Heart Research Institute team led by first author Yunduo Charles Zhao and senior author Lining Arnold Ju. The researchers reconstructed carotid arteries from six patients, modeled blood flow with computational fluid dynamics, then used a laser to injure the underlying collagen and observe clotting, terming the setup a "physical twin."

3D vessel shape and local flow disturbances, not the percent of narrowing, were the better predictors of clot behavior. The mechanism centers on von Willebrand factor, a protein that binds exposed collagen at sites of endothelial injury, recruits platelets, and drives clot formation. The chip dissects how that VWF presentation changes under patient-specific flow.

This is proof of concept, not a bedside tool. The team is now recruiting stroke patients for a trial, first in recurrent cases or where clinicians have multiple strategies but limited functional data to choose between them.

Stroke remains the world's second-leading cause of death, with roughly one in five ischemic strokes tracing to fatty plaque in arteries like the carotid. Whether this chip changes that is the trial's question.