title: Synergism of rheolytic thrombectomy and embolic distal protection using the percusurge guard wire for fresh thrombus removal: an in vitro study.
abstract: 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.
authors.affiliation: The Cardioquest Research Laboratories, Tampa, Florida 33609, USA. fmatar@fciheart.com
authors.forename: Fadi
authors.initials: F
authors.lastname: Matar
authors.forename: Kathy
authors.initials: K
authors.lastname: Gloer
authors.forename: Chantel
authors.initials: C
authors.lastname: Barrett
authors.forename: Olivia
authors.initials: O
authors.lastname: Sires
authors.forename: Shaival
authors.initials: S
authors.lastname: Thakore
authors.forename: Jennifer
authors.initials: J
authors.lastname: Warner
authors.forename: J
authors.initials: J
authors.lastname: Thompson Sullebarger
authors.forename: George
authors.initials: G
authors.lastname: Ebra
mesh_terms: 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*