Percutaneous transluminal coronary angioplasty with hemoperfusion

Balloon inflation time during percutaneous transluminal coronary angioplasty (PTCA) is limited by the patient's tolerance to ischemia. A nonpulsatile, variable flow rate syringe pump that develops pressures up to 200 psi has been developed, along with PTCA catheters capable of delivering 0-70 cc/min of blood across a lesion at these pressures. Using this system, 110 patients have been treated with active hemoperfusion during routine PTCA. In eight cases, no preperfusion tolerated inflation time was obtained. In 96 of 102 cases, the tolerated inflation time was increased by at least 50%, for a success rate of 94%. This study demonstrated that active hemoperfusion during PTCA prolongs tolerated inflation time. The catheters and pump are capable of performing routine PTCA, supported when necessary by active hemoperfusion.