[Risk of embolism in diagnostic and therapeutic intravascular procedures--in vitro model]

The purpose of the study was to evaluate the risk of distal embolisation in a silicon model during different endovascular diagnostic and therapeutic procedures. Endovascular technics, such as guidewire and catheter advancement, metal stent placement, balloon angioplasty and thrombectomy device were compared. Clots were produced from human blood sample. The transparent silicon model was filled with saline, flow was generated by an hydraulic pump. Stenosis was created by mechanical compression. The size of the circulating particles were measured with a mesh of nylon filters. No loose particles were detected using guidewire, pigtail and straight catheters. Balloon inflation induced embolisation of particles ranging from 100 microns-12 mm in length. Deployment of self expandable metallic stents did not result in particle migration but secondary angioplasty inside the stent detached particles (ranging from 400 microns to 12 mm in length). Use of thrombectomy device resulted in significant particle migration (ranging from 400 microns to 1500 microns in length).