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[The diagnosis and fragmentation therapy of acute massive pulmonary embolism with a rotatable pigtail catheter:
T Schmitz-Rode1, R W Günther, J Neuerburg
1Klinik für Radiologische Diagnostik, Klinikum der RWTH Aachen.
Purpose:
A dedicated pigtail catheter system which allows angiographic documentation and adjunctive mechanical fragmentation of pulmonary emboli was evaluated in an animal experiment.
Material And Method:
The 5-F catheter provided with an oval side hole proximal to the pigtail tip was rotated manually or with an electric drive, and with the wire as a rotation axis. Pulmonary embolic occlusions were recanalized in ten dogs. Catheter positioning, monitoring, rotation behaviour, safety and fragmentation properties were assessed.
Results:
The catheter system was rapidly positioned and easily monitored in the pulmonary arteries. On average, 55% (+/- 20%) of the embolic occlusions were recanalized. Embolus fragmentation reduced the emboli-induced increase of the pulmonary arterial mean pressure by 72%. In three dogs, histology revealed slight perivascular haemorrhage.
Conclusion:
Partial recanalisation of the pulmonary arteries was achieved rapidly with relative ease of instrumentation. Since fragmentation technique is an adjunct to the commonly performed pigtail catheterization of the pulmonary arteries, no special training is required.