LOCAL INTRAARTERIAL THROMBOLYSIS - IN-VITRO COMPARISON BETWEEN AUTOMATIC AND MANUAL PULSE-SPRAY INFUSION

Purpose: Manual and automatic pulse-spray infusion techniques are comp ared in vitro to evaluate the efficacy of thrombolysis and the distrib ution of urokinase and saline solution within thrombus using a pulse-s pray catheter. Methods: A pulse-spray catheter was introduced into a h uman thrombus within a stenotic how model. Automatic and manual pulsed infusion of urokinase and automatic pulsed infusion of saline solutio n were compared. To quantify the efficacy of thrombolysis, pressure gr adients were recorded proximal and distal to the thrombus and during t he course of infusion. Distribution of infused urokinase was assessed radiographically. Results: The fastest and most homogeneous dissolutio n of the thrombus was achieved with automatic pulsed infusion of uroki nase, shown by decreasing transthrombotic pressure gradients (p < 0.00 1, Wilcoxon, matched pairs). Manual pulsed infusion of urokinase or sa line solution resulted in inhomogeneous thrombus dissolution and delay ed thrombolysis. Conclusion: Application of automatic pulse-spray inje ctors seems beneficial for more effective and homogeneous intraarteria l pulse-spray thrombolysis when compared with conventional manual puls ed technique.