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Injury potential to venous valves from the Amplatz thrombectomy device
M J Sharafuddin1, X Gu, Y M Han
1Department of Radiology, University of Iowa Hospitals & Clinics, Iowa City, USA.
Journal of Vascular and Interventional Radiology : JVIR
|June 29, 2000
Summary
The Amplatz thrombectomy device (ATD) showed no significant peripheral venous valve injury in canine veins 7 mm or larger. Smaller veins (≤6 mm) experienced more frequent injury during ATD thrombectomy, necessitating further functional assessment.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Evaluation
Background:
- Peripheral venous valve injury is a concern during thrombectomy procedures.
- The Amplatz thrombectomy device (ATD) is used for clot removal.
- Assessing device-specific impacts on venous anatomy is crucial for patient safety.
Purpose of the Study:
- To evaluate the acute effects of the Amplatz thrombectomy device (ATD) on peripheral venous valves.
- To determine the relationship between vein diameter and valve injury during ATD use.
- To compare ATD effects with a standard sheath-dilator control in a canine model.
Main Methods:
- ATD thrombectomy was performed on 17 canine veins; four veins served as controls using an 8-F sheath-dilator.
- Pre- and post-thrombectomy venography assessed venous integrity.
- Explanted veins underwent histopathologic examination to grade valve injury (0-4).
Main Results:
- No significant valve injury (grade 0) occurred in ATD-treated veins ≥7 mm in diameter (n=5).
- Mild to moderate-to-severe injury (grades 1-4) was observed in 7 of 12 ATD-treated veins ≤6 mm in diameter (P < .03).
- Control sheath-dilator treatment resulted in no injury in four veins.
Conclusions:
- Veins measuring 7 mm or greater in diameter demonstrated no significant acute valvular injury with ATD thrombectomy.
- The risk of venous valve injury appears higher in smaller diameter veins (≤6 mm) during ATD use.
- Further studies are required to assess the long-term and short-term functional consequences of any observed valvular changes.
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