ACUTE MASSIVE PULMONARY-EMBOLISM - USE OF A ROTATABLE PIGTAIL CATHETER FOR DIAGNOSIS AND FRAGMENTATION THERAPY

PURPOSE: A modified pigtail catheter for angiographic documentation an d mechanical fragmentation of pulmonary embolism was evaluated for its efficacy and safety. MATERIALS AND METHODS: Rotation of the 5-F pigta il catheter was performed with an electric drive or a handle. The wire left an oval side hole at the outer curvature and served as an axis o f rotation. Fragmentation properties were assessed in vitro. Pulmonary positioning, steerability, rotation behavior, and safety were tested in six pigs. Pulmonary embolic occlusions were recanalized in eight do gs. RESULTS: The catheter system was promptly positioned and easily st eered in the pulmonary arteries. On average, 53% of the occluded pulmo nary arteries were recanalized. Recanalization reduced the emboli-indu ced elevation of the pulmonary artery mean pressure by 73%. Slight per ivascular hemorrhage occurred in three dogs. CONCLUSION: Rapid partial recanalization was achieved with relative ease of instrumentation. Th e technique is an extension of the commonly performed pigtail catheter ization of the pulmonary arteries, which may increase its clinical acc eptance.