Comparative in vitro study of two percutaneous hydrodynamic thrombectomy systems.
OBJECTIVE
To test the efficacy of clot removal in small- and large-caliber vessels and determine the extent of procedure-related particle embolization for two rheolytic thrombectomy devices, the Hydrolyser and Angiojet.


METHODS
Both systems were applied with and without guiding catheters in an arterial (7-mm tube diameter, wall-adherent thrombus [mean, 5.3 g], flow of 500 mL/min)and a venous (20-mm tube diameter, free-floating thrombus [mean, 12 g], flow of 1,500 mL/min) flow model.


RESULTS
Particle embolization was significantly lower for the Angiojet device (mean, 1.8% +/- 2.9 [standard deviation] vs mean 4.8% +/- 6.1 for particles > 1,000 microns). When the devices were used without guiding catheters, mean clot removal rates were 65% +/- 12 with the Hydrolyser and 49% +/- 9.2 with the Angiojet in the arterial flow model and 88% +/- 15.5 with the Hydrolyser and 85% +/- 17.8 with the Angiojet in the venous flow model. Significant improvements in clot removal rates were achieved with use of guiding catheters: 81% +/- 5.4 with the Hydrolyser and 89% +/- 3.9 with the Angiojet in the arterial flow model and 95% +/- 1.4 with the Hydrolyser and 97% +/- 0.84 with the Angiojet in the venous flow model.


CONCLUSIONS
Use of guiding catheters improved the performance of both systems significantly. Both rheolytic catheters remove sufficient amounts of soft thrombus from a large-caliber vessel, especially when applied with a guiding catheter. However, firmer thrombus is difficult to remove. The particle embolization rate is low for both systems.
Bücker
A
A
Clinic for Diagnostic Radiology, University of Technology Aachen, Germany.
Schmitz-Rode
T
T
Vorwerk
D
D
Günther
R W
RW
D000818:Animals; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D004867:Equipment Design; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008955:Models, Cardiovascular; D013552:Swine; D017131:Thrombectomy / Q000295:instrumentation*