Related Experiment Video
Updated: Aug 14, 2026
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombectomy for acute internal carotid thrombosis: five thrombectomy devices compared
H Chant1, R Ashleigh, C McCollum
1Department of Vascular Surgery, Bristol Royal Infirmary, UK.
Insights
The Hydrolyser and Clot Buster thrombectomy catheters are safest and most effective for clearing internal carotid artery (ICA) thrombosis, unlike balloon embolectomy which risks further embolic damage.
Area of Science:
- Medical Devices
- Vascular Surgery
- Interventional Neurology
Background:
- Internal carotid artery (ICA) thrombosis poses a significant risk of ischemic stroke.
- Effective thrombectomy is crucial for restoring blood flow and preventing neurological deficits.
- Commercially available thrombectomy devices vary in their safety and efficacy profiles.
Purpose of the Study:
- To evaluate the safety and efficiency of five commercially available thrombectomy catheters in simulated ICA thrombosis.
- To compare thrombus removal rates, pressure dynamics, and distal embolization potential across different devices.
Main Methods:
- A comparative in vitro study was conducted using a simulated ICA model filled with human thrombus.
- Five thrombectomy devices were tested under varying back pressures (10 and 30 cm H2O).
- Thrombus clearance, tip pressure changes, and distal embolization were assessed using flow cytometry.
Main Results:
- AngioJet demonstrated the highest thrombus clearance (95%), while Acolysis System showed the least (34%).
- Hydrolyser and Clot Buster generated only negative tip pressures, indicating a safer profile.
- Fogarty balloon catheter at 10 cm H2O resulted in the greatest distal embolization (P<0.05).
Conclusions:
- Balloon embolectomy for ICA thrombosis carries a risk of further embolic cerebral damage.
- The Hydrolyser and Clot Buster devices show significant promise for safe and effective ICA thrombectomy.
- Device selection is critical to optimize outcomes and minimize complications in thrombectomy procedures.
Objective:
To test the safety and efficiency of commercially available thrombectomy catheters in clearing simulated internal carotid artery (ICA) thrombosis.
Design:
Comparative in vitro study.
Materials And Methods:
A model of the ICA was filled with human thrombus, the 'circle of Willis' back pressure was set at either 10 or 30 cm of water. Five thrombectomy devices (Hydrolyser, Clot Buster, Acolysis System, AngioJet and Fogarty embolectomy catheter) were compared for (i) efficiency at removing thrombus, (ii) pressure changes at the tip of each device, and (iii) distal embolisation by flow cytometry.
Results:
Thrombus clearance was greatest with the AngioJet (median 95%, range 92-97%) and least with the Acolysis System (median 34%, range 12-50%). The Clot Buster and Hydrolyser were safest as they produced only negative tip pressures, the AngioJet and Balloon catheter produced positive and negative pressures risking distal embolisation. The Acolysis system produced no pressure change during use. Distal embolisation (of particles between 5 and 40 microm diameter) was greatest with the Fogarty balloon catheter at 10 cm water (P<0.05) and least with the Hydrolyser and Clot Buster.
Conclusion:
Balloon embolectomy for ICA thrombosis risks further embolic cerebral damage. The Hydrolyser and the Clot Buster show the greatest promise for ICA thrombectomy.
