Objective:

This review systematically evaluates the strengths, limitations, and applications of all major human-based thrombectomy models, static cadaveric, perfused cadaveric, and ex vivo vascular tissues, in order to provide a comparative framework for their role in preclinical development.

Background:

Ischemic stroke remains a leading cause of disability and mortality, with mechanical thrombectomy (MT) revolutionizing outcomes for large-vessel occlusions. Device development and training rely heavily on preclinical testing platforms, yet animal and bench-top models fail to replicate the complexity of human cerebrovasculature. While prior reviews have largely focused on single models (e.g., cadaveric heads), a comprehensive comparison of the full spectrum of human-derived models is lacking.

Design/Methods:

A structured literature review was conducted, analyzing publications on human thrombectomy models. Emphasis was placed on anatomical fidelity, capacity to replicate physiological conditions, feasibility for device testing, and reported outcomes including clot retrieval success, vessel trauma, embolic risk, and navigation metrics.

Results:

Cadaveric models offer unmatched anatomical accuracy for device navigation and access training but lack hemodynamic realism. Perfused cadaveric heads overcome this by simulating physiological blood flow, enabling dynamic evaluation of recanalization efficacy (e.g., TICI scoring) and distal embolization, though at the cost of complex setup and short viability. Ex vivo vascular tissues allow high-resolution study of vessel device interactions and histological assessment of endothelial trauma, but they cannot replicate the full systemic procedure and suffer from variability in tissue quality. Together, these models provide complementary insights that single model studies cannot achieve.

Conclusions: