Rotational approaches to atherectomy and thrombectomy.
We have developed and tested a rotational, mechanical approach to arterial plaque removal (PTRA or Percutaneous Transluminal Rotational Atherectomy). An elliptical burr is rotated by a helical driveshaft at 150,000 rpm. The tip of the burr is embedded with small diamond chips, 30 micron in diameter. Plaque is thus abraded and particles of 2-5 micron in diameter are released downstream. Preliminary studies in a rabbit model of iliac atherosclerosis showed a reduction in percent diameter stenosis from more than 80% to less than 40%. Perforations are the current principal complication, occurring in 2 of the 13 rabbit arteries. A second rotational catheter system has been developed for removal of fresh thrombus (PRT-Percutaneous Rotational Thrombectomy). Low speed rotation (5000 rpm) of a non-cutting catheter promotes the selective winding of fibrin with subsequent lysis of thrombus. This was effective in 20 out of 21 total thrombotic occlusions in a canine model of fresh clot, with a single perforation early in the experiment.
Ritchie
J L
JL
Department of Medicine, University of Washington, School of Medicine, Seattle.
Hansen
D D
DD
Intlekofer
M J
MJ
Hall
M
M
Auth
D C
DC
D000818:Animals; D001161:Arteriosclerosis / Q000601:surgery*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D004285:Dogs; D053685:Laser Therapy / Q000295:instrumentation*; D011817:Rabbits; D012399:Rotation; D013927:Thrombosis / Q000601:surgery*