DISTAL EMBOLIZATION DURING THROMBECTOMY WITH USE OF THE HYDROLYSER (HYDRODYNAMIC THROMBECTOMY CATHETER) - IN-VITRO TESTING

PURPOSE: To evaluate distal embolization while using the Hydrolyser (h ydrodynamic thrombectomy catheter) with special attention to the sever ity of the stenosis and temporary distal or proximal flow obstruction. MATERIALS AND METHODS: The Hydrolyser procedure was assessed in plast ic tubes (5-8 mm) with a 70% or 90% diameter stenosis with or without temporary distal flow obstruction and a 72-hour-old clot proximal to t he stenosis, The weight of the embolized particles was established aft er passage through filters of 1,000, 500, 100, and 10 mu m. To evaluat e the influence of the absolute inner diameter of the stenosis 1.0-, 2 .1-, and 3.0-mm stenoses were compared in 10-mm tubes. RESULTS: Thromb us removal was greater than 99.9% in all but one of the cases in the 5 -8-mm tubes, Embolization with a weight of more than 1 mg was only fou nd in tubes with a relative stenosis of 70% and a stenosis inner diame ter of greater than 1.5 mm, There was a positive relationship between inner diameter of the stenosis and the amount of distal embolization, In the presence of a proximal or distal temporary flow obstruction dur ing thrombectomy, no distal embolization greater than 1 mg was found. CONCLUSION: In this in vitro study, the Hydrolyser thrombectomy device demonstrated minimal distal embolization, The amount of distal emboli zation that did occur was related to the absolute stenosis diameter an d could be prevented by a severe distal stenosis and/or a temporary pr oximal or distal flow obstruction.