MECHANICAL THROMBECTOMY WITH THE AMPLATZ DEVICE - HUMAN-EXPERIENCE

PURPOSE: The authors present their early experience of mechanical arte rial and graft thrombectomy with the Amplatz thrombectomy device. PATI ENTS AND METHODS: Preliminary data are presented for 14 patients treat ed with the Amplatz thrombectomy catheter. The procedure was carried o ut in 10 arterial polytetrafluoroethylene grafts, in two native arteri es, and in two patients with venous thrombosis. RESULTS: The thrombect omy catheter completely removed the clot in 11 patients and partially removed clot in three patients. Mean thrombectomy time was 2 minutes 4 5 seconds. Despite distal blood pressure cuff occlusion, two instances of insignificant distal embolization occurred. Mechanical clot dissol ution has consistently produced hemolysis without adverse clinical eff ects. The underlying causative factors such as stenoses were treated b y means of angioplasty, atherectomy, or surgical endarterectomy. CONCL USION: Mechanical thrombectomy with this device is a new, effective te chnique and can rapidly remove the thrombus. From preliminary results, the device seems most promising in clearing out thrombi in occluded s ynthetic femoral-to-popliteal bypass grafts. The device could have wid er application if it were steerable and if it could be introduced from the contralateral approach.