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Evaluation of venous injury caused by a percutaneous mechanical thrombolytic device
A Lajvardi1, S O Trerotola, J D Strandberg
1Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Purpose:
To study venous injury caused by a prototype percutaneous mechanical thrombolytic device.
Methods:
Simulated thrombolysis was performed using the device, or the Fogarty balloon catheter (FBC) as control, in the infrarenal inferior vena cava (IVC) of 40 New Zealand white rabbits. Venous injury was evaluated by cavography, Evans blue dye staining, and histology at 0, 1, and 6 weeks postprocedure.
Results:
Both devices resulted in near complete endothelial denudation acutely. No differences in reendothelialization were noted at any time in the proximal and mid-IVC, but there was significantly greater reendothelialization in the distal IVC in the rabbits treated 6 weeks earlier with the device (p < or = 0.04). Additionally, the inner luminal diameter at necropsy for the 1-week rabbits treated with the FBC was significantly narrower in the distal and middle sections of the IVC when compared with the device (p < or = 0.02 for both segments). There was no luminal diameter difference at 0 or 6 weeks.
Conclusion:
Based on a rabbit model, venous injury from the device was found to be similar to, and in the distal IVC less than, the routinely used FBC.