Thermal Changes during Rheolytic Mechanical Thrombectomy.

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Biomedical Engineering

Background:

• Rheolytic thrombectomy (RT) is an endovascular technique used to remove thrombi.
• Understanding the thermal effects and potential tissue injury associated with RT is crucial for clinical safety.

Purpose of the Study:

• To quantify thermal changes induced by RT in an ex vivo human saphenous vein model.
• To assess endothelial and vessel wall injury following RT treatment.

Main Methods:

• Human saphenous vein segments were subjected to continuous or pulsed RT in a perfusion system.
• Temperature was monitored continuously, and vessel wall thickness, endothelial integrity (CD31), and heat shock protein 90 (HSP90) expression were analyzed post-treatment.

Main Results:

• Both continuous and pulsed RT significantly increased venous segment temperature, with no significant difference between modes.
• RT treatment led to significant intima/media thinning and a reduction in intact endothelium.
• Heat shock protein 90 expression showed a non-significant increase post-RT.

Conclusions:

• Rheolytic thrombectomy reproducibly elevates vessel temperature and causes significant endothelial and vessel wall injury in an ex vivo venous model.
• Clinical application of RT should consider strategies to minimize prolonged application to focal vascular segments to reduce injury.