Synergism of rheolytic thrombectomy and embolic distal protection using the percusurge guard wire for fresh thrombus removal: an in vitro study.
OBJECTIVE
To test the effectiveness of Rheolytic Thrombectomy (RT) and distal protection balloon wires when used synergistically in an in vitro model.


BACKGROUND
Although effective, currently available technologies may not be individually ideal for fresh clots removal.


METHODS
Fourteen, fresh blood samples were placed in 14 plastic tubes and left to clot for 6 h. A Percusurge Guardwire balloon was inflated distal to the clot and aspiration was performed using RT in seven tubes and manual aspiration (MA) with the Export catheter in seven tubes. The residual clot in each tube was dried and weighed. Both aspiration systems were advanced over the Guardwire.


RESULTS
During RT, none of the protection balloons ruptured and no retrograde clot embolization were observed. MA was most effective when the Export catheter tip was not in direct contact with the clot. The residual clot mass post RT was significantly less than post MA (9.7+/-2.2 versus 59.2+/-45.9, P = 0.01).


CONCLUSIONS
RT is compatible with Distal Protection Balloon Wires and results in more complete clot removal than manual aspiration with the export catheter. Although manual aspiration results in a large variation in extraction efficacy, it is most effective when direct catheter-clot contact is kept to a minimum.
Matar
Fadi
F
The Cardioquest Research Laboratories, Tampa, Florida 33609, USA. fmatar@fciheart.com
Gloer
Kathy
K
Barrett
Chantel
C
Sires
Olivia
O
Thakore
Shaival
S
Warner
Jennifer
J
Thompson Sullebarger
J
J
Ebra
George
G
D000800:Angioplasty, Balloon / Q000295:instrumentation*; D004617:Embolism / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D006801:Humans; D066298:In Vitro Techniques; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation*; D013927:Thrombosis / Q000601:surgery*