Injury potential to venous valves from the Amplatz thrombectomy device.
OBJECTIVE
To evaluate the acute effects of the Amplatz thrombectomy device (ATD) on peripheral venous valves in a canine model.


METHODS
ATD thrombectomy was performed in 17 veins, and control experiments with use of an 8-F sheath-dilator were performed in four veins. Prethrombectomy ascending venography was performed, followed by device passage across the vein segment. Post-thrombectomy ascending venography was then performed, followed by heparinization and euthanasia. The treated veins were carefully explanted and stored in formaldehyde for histopathologic examination. Severity of valve injury was graded on a scale of 0 to 4.


RESULTS
In ATD-treated veins: 10 veins sustained no injury [grade 0] (diameter, 6.7 mm +/- 1.7; antegrade/retrograde approach, 5/5), five veins sustained mild injury [grade 1-2] (diameter, 5.2 mm +/- 0.8; antegrade/retrograde, 3/2), while the remaining two veins sustained moderate-to-severe injury [grade 3-4] (diameter, 5 and 6 mm; antegrade/retrograde, 1/1). In sheath-dilator treated veins: no injury [grade 0] in any of the four treated veins (mean diameter, 5.5 mm +/- 0.6; all retrograde). In ATD-treated veins, valve injury (of any grade) was significantly more frequent in veins 6 mm or less in diameter than in veins at least 7 mm in diameter (seven of 12 vs zero of five; P < .03). There was no significant association between thrombectomy approach and injury grade.


CONCLUSIONS
Veins 7 mm or greater in diameter were associated with no significant valve injury during ATD thrombectomy. However, long-term and short-term effects on valvular function will need to be assessed.
Sharafuddin
M J
MJ
Department of Radiology, University of Iowa Hospitals & Clinics, Iowa City, USA.
Gu
X
X
Han
Y M
YM
Urness
M
M
Gunther
R
R
Amplatz
K
K
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage; D001367:Axillary Vein / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D016009:Chi-Square Distribution; D003094:Collagen; D004285:Dogs; D004730:Endothelium, Vascular / Q000293:injuries / Q000473:pathology; D004867:Equipment Design; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D005337:Fibrin; D005404:Fixatives; D005557:Formaldehyde; D006470:Hemorrhage / Q000473:pathology; D006493:Heparin / Q000008:administration & dosage; D010690:Phlebography; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D013499:Surface Properties; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation*
D000925:Anticoagulants; D005404:Fixatives; D005557:Formaldehyde; D005337:Fibrin; D006493:Heparin; D003094:Collagen