LOCAL INTRAARTERIAL THROMBOLYSIS - IN-VITRO COMPARISON OF VARIOUS INFUSION CATHETERS

Purpose: Catheters are compared in vitro to evaluate the efficacy of t hrombolysis during urokinase infusion within the thrombus. Methods: Si x catheters were introduced individually into human thrombus within a stenotic flow model. Urokinase was infused continuously into the throm bus. To quantify the efficacy of thrombolysis, pressure gradients were recorded proximal and distal to the thrombus and during the course of infusion. Uniformity of lysis was assessed radiographically. Results: The fastest and most homogeneous thrombolysis was achieved with the E DM and the straight-flush catheter, shown by decreasing transthromboti c pressure gradients. All other catheter designs showed less homogeneo us and delayed thrombolysis (p less than or equal to 0.001, Friedmann- Test, Schaich-Hamerle). There was no significant difference in the eff icacy of thrombus dissolution between the EDM and the straight-flush c atheter (Wilcoxon, matched pairs, p > 0.7). Conclusion: The EDM cathet er and the straight flush catheter achieved the most homogeneous and f astest thrombolysis, apparently due to the best urokinase distribution within the thrombus.