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Rheolytic catheter for percutaneous removal of thrombus
W J Drasler1, M L Jenson, G J Wilson
1Possis Medical, Minneapolis, MN 55427.
Insights
A novel rheolytic thrombectomy catheter (RTC) uses high-velocity saline jets to effectively dissolve and remove blood clots. This percutaneous system shows promise for treating vascular occlusions in various vessel sizes.
Area of Science:
- Biomedical Engineering
- Vascular Surgery
- Interventional Radiology
Background:
- Thrombus formation poses significant risks, necessitating effective removal methods.
- Current treatments like thrombolysis can be slow and may not be suitable for all cases.
- Percutaneous approaches offer less invasive alternatives for clot removal.
Purpose of the Study:
- To introduce and evaluate a novel percutaneous thrombectomy system utilizing rheolytic technology.
- To assess the efficacy and safety of the rheolytic thrombectomy catheter (RTC) in clot lysis and removal.
Main Methods:
- Development of a rheolytic thrombectomy catheter (4-6 F) designed to deliver high-velocity saline jets.
- In vitro testing using whole blood clots in simulated vascular tubing (6-9 mm diameter).
- In vivo evaluation in a canine femoral artery model to assess clot removal and vessel integrity.
Main Results:
- Complete dissolution and removal of 10-15 cm blood clots in vitro within 1 minute.
- Successful lysis and removal of clots from a canine femoral artery in vivo.
- No observed vessel damage during in vivo experiments.
Conclusions:
- The rheolytic thrombectomy catheter (RTC) demonstrates high efficacy in rapid clot lysis and removal.
- The system's design (small caliber, flexibility) suggests potential for treating diverse vascular occlusions.
- RTC offers a promising percutaneous alternative for managing thrombus in challenging anatomical locations.
Abstract:
The authors present a percutaneous thrombectomy system (rheolytic thrombectomy catheter [RTC]) in which high-velocity jets of saline solution are used to lyse and remove thrombus. The catheters (4-6 F) direct a 10,000-15,000-psi (0.7-1.05 x 10(5)-kPa) jet of saline solution onto an exhaust port from orifices at the end of the catheter. The jet entrains clot and resulting fragments and brings them into the high-velocity region for lysis and removal. Whole blood clots (10-15 cm) placed in 6-9-mm-diameter tubing were completely dissolved and removed with the RTC in less than 1 minute. In vivo use in a canine model resulted in lysis and removal of clots from a femoral artery, without vessel damage. The small caliber, flexibility, and effective lysis of this system suggest its potential usefulness in large central vessels that are difficult to access surgically and in small-diameter vessels that require more rapid removal of thrombus than can be achieved with thrombolytic therapy.