Comparison of the mechanical thrombectomy efficacy of the Amplatz thrombectomy device and the Cragg thrombolytic brush in vitro.
OBJECTIVE
To determine the efficacy of thrombectomy (without thrombolytic agents) for the Amplatz thrombectomy device (ATD) and the Cragg thrombolytic brush catheter (CBC) in vitro.


METHODS
Thrombectomy was performed with the ATD or CBC (6F) in a flow model. Embolus sizes, weight, remaining thrombus, and activation time were evaluated.


RESULTS
No significant difference in the activation time was found. The CBC produced significantly less embolism (3.3% vs. 0.03% in the 5-mm and 89% vs. 0.5% in the 7-mm model), but also much more thrombus remained in the system than with the ATD (1% vs. 41% in the 5-mm and 0.1% vs. 62% in the 7-mm model).


CONCLUSIONS
The ATD can remove almost all thrombus (99%), whereas the CBC removes only up to 60%, producing fewer emboli than the ATD. This might be due to the lower rotational speed of the CBC compared with the ATD, which is 20 times greater. The soft nylon brush offers less resistance and shear force toward the thrombus than the stainless-steel impeller of the ATD. Because of the large amount of remaining thrombus, the CBC should not be used without lytic agents.
Grimm
J
J
Klinik für Diagnostische Radiologie an der Christian Albrechts Universität zu Kiel, Kiel, Germany. grimm@rad.uni-kiel.de
Müller-Hülsbeck
S
S
Heller
M
M
D002404:Catheterization; D004617:Embolism / Q000209:etiology; D004867:Equipment Design; D006801:Humans; D008955:Models, Cardiovascular; D008961:Models, Structural; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation*