M. Zwaan et al., In vitro evaluation of different embolectomy catheters for the treatment of acute pulmonary embolism., ROFO-F RONT, 171(6), 1999, pp. 485-491
Citations number
30
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging
Journal title
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN
Introduction: Pulmonary embolism (PE) ist one of the most common cardiovasc
ular diseases and frequently causes death. As a rule, PE is treated with th
rombolytic therapy or surgical thrombectomy. Materials and Methods: In an i
n vitro model of the right lung, we tested four different percutaneous tran
sluminal thrombectomy devices: a pigtail-catheter with an angled 3-cm (40 d
egrees) distal tip, the clot-buster, the hydrolyser catheter, and a modifie
d hydrolyser. In 16 consecutive and repetitive experiments fresh thrombi we
re inserted and we evaluated the effectiveness of the system with respect t
o time, fragment size, reduction of the Miller score, and handling. Results
: Mean intervention times of the catheter systems were 23 min (pigtail), 14
.4 min (modified hydrolyser), 13.8 min (clot-buster), and 10.8 min (hydroly
ser). The maximum size of the produced fragments range from 0.5 to 3.5 mm b
y the pigtail and from 0.5 to 1 mm by the other systems. The Miller score r
eduction was from 14.4 to 2.8 (pigtail), 13.8 to 1.8 (clot-busters), 14.6 t
o 1.2 (hydrolyser), and 16.4 to 1 (modified hydrolyser). Discussion: All fo
ur catheter systems were effective in the treatment of pulmonary embolism.
The pigtail catheter is the most simple system but more time consuming and
less effective in the fragmentation of emboli and reduction of the Miller s
core compared to the other three catheter systems. These systems were compa
rable in our model but especially the handling of the hydrolyser was encour
aging.