[The in-vitro evaluation of different embolectomy catheters for the treatment of acute pulmonary embolism].
BACKGROUND
Pulmonary embolism (PE) is one of the most common cardiovascular diseases and frequently causes death. As a rule, PE is treated with thrombolytic therapy or surgical thrombectomy.


METHODS
In an in vitro model of the right lung, we tested four different percutaneous transluminal thrombectomy devices: a pigtail-catheter with an angled 3-cm (40 degrees) distal tip, the clot-buster, the hydrolyser catheter, and a modified hydrolyser. In 16 consecutive and repetitive experiments fresh thrombi were inserted and we evaluated the effectiveness of the system with respect to 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 (hydrolyser). The maximum size of the produced fragments range from 0.5 to 3.5 mm by the pigtail and from 0.5 to 1 mm by the other systems. The Miller score reduction was from 14.4 to 2.8 (pigtail), 13.8 to 1.8 (clot-busters), 14.6 to 1.2 (hydrolyser), and 16.4 to 1 (modified hydrolyser).


CONCLUSIONS
All four 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 score compared to the other three catheter systems. These systems were comparable in our model but especially the handling of the hydrolyser was encouraging.
Zwaan
M
M
Institut für Diagnostische und Interventionelle Radiologie, Kernspintomographie und Nuklearmedizin, Ammerland-Klinik, Westerstede. zwaan@ammerland-klinik.de
Kripke
N
N
Lorch
H
H
Weiss
H D
HD
D000208:Acute Disease; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000706:statistics & numerical data; D017128:Embolectomy / Q000295:instrumentation* / Q000706:statistics & numerical data; D004867:Equipment Design / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D006801:Humans; D066298:In Vitro Techniques; D008953:Models, Anatomic; D011651:Pulmonary Artery; D011655:Pulmonary Embolism / Q000601:surgery*; D013997:Time Factors