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Cardiovasc Intervent Radiol. 1996 May-Jun;19(3):165-9.

Fragmentation of pulmonary emboli: in vivo experimental evaluation of two high-speed rotating catheters.

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1
Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, D-52057 Aachen, Germany.

Abstract

PURPOSE:

To test two over-the-wire systems for fragmentation of pulmonary emboli.

METHODS:

In 11 dogs, 22 embolic occlusions of lobar or central pulmonary arteries were performed by injection of preformed emboli through a jugular vein sheath. A commercially available device (thrombolizer) and a modified version of the impeller catheter were introduced via the femoral vein and positioned at the embolus site.

RESULTS:

Catheter placement at the site of the emboli was possible. In more than half of the cases a hydrophilic or an extra-stiff guidewire was necessary. The thrombolizer did not rotate properly with its original pneumatic drive and required a major modification. When sufficient rotation was provided, both fragmentation catheters were able to clear the occluded main arteries. Side branches were partly obstructed by the resulting fragments. Recanalization led to a reduction of the emboli-induced elevation of the pulmonary arterial pressure by two-thirds. Histology of the recanalized pulmonary artery segments revealed localized (impeller catheter) and widespread (thrombolizer) periarterial hemorrhage.

CONCLUSION:

Embolus fragmentation led to a hemodynamic improvement. The impeller catheter was less traumatic compared with the thrombolizer, which was technically insufficient.

PMID:
8661643
[Indexed for MEDLINE]
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