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Comparative in vitro study of two percutaneous hydrodynamic thrombectomy systems
A Bücker1, T Schmitz-Rode, D Vorwerk
1Clinic for Diagnostic Radiology, University of Technology Aachen, Germany.
Summary
Guiding catheters significantly improve rheolytic thrombectomy device performance for soft clot removal in large vessels. Both Hydrolyser and Angiojet devices show low particle embolization rates, though firmer thrombi remain challenging.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Rheolytic thrombectomy devices are used to remove blood clots.
- Optimizing device performance and understanding embolic risks are crucial for patient safety and treatment efficacy.
Purpose of the Study:
- To evaluate the clot removal efficacy of the Hydrolyser and Angiojet rheolytic thrombectomy devices.
- To assess procedure-related particle embolization associated with these devices in small and large vessels.
Main Methods:
- Two rheolytic thrombectomy systems, Hydrolyser and Angiojet, were tested in arterial (7-mm) and venous (20-mm) flow models.
- Models simulated wall-adherent and free-floating thrombi with varying flow rates.
- Device performance was assessed with and without guiding catheters.
Main Results:
- Guiding catheters significantly improved clot removal rates for both devices in both arterial and venous models.
- Angiojet demonstrated significantly lower particle embolization rates (>1,000 microns) compared to Hydrolyser.
- Clot removal rates ranged from 49% to 97% depending on the device, vessel type, and use of guiding catheters.
Conclusions:
- Guiding catheters enhance the effectiveness of both Hydrolyser and Angiojet for soft thrombus removal, particularly in large vessels.
- Both devices exhibit low particle embolization rates.
- Removal of firm thrombi remains a limitation for these rheolytic thrombectomy systems.