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A new rotational thrombectomy catheter: System design and first clinical experiences

Schmitt, Hans-Erich ; Jäger, Kurt ; Jacob, Augustinus ; Mohr, Helmuth ; Labs, Karl-Heinz ; Steinbrich, Wolfgang

In: CardioVascular and Interventional Radiology, 1999, vol. 22, no. 6, p. 504-509

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    Title
    • A new rotational thrombectomy catheter: System design and first clinical experiences
    Author
    • Schmitt, Hans-Erich. Department of Diagnostic Radiology, University Hospital Basel, Kantonsspital, CH-4031, Basel, Switzerland
    • Jäger, Kurt. Department of Medicine, Division of Angiology, University Hospital Basel, Kantonsspital, CH-4031, Basel, Switzerland
    • Jacob, Augustinus. Department of Diagnostic Radiology, University Hospital Basel, Kantonsspital, CH-4031, Basel, Switzerland
    • Mohr, Helmuth. Straub Medical, Straubstrasse, CH-7323, Wangs, Switzerland
    • Labs, Karl-Heinz. Department of Medicine, Division of Angiology, University Hospital Basel, Kantonsspital, CH-4031, Basel, Switzerland
    • Steinbrich, Wolfgang. Department of Diagnostic Radiology, University Hospital Basel, Kantonsspital, CH-4031, Basel, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • CardioVascular and Interventional Radiology, 1999, vol. 22, no. 6, p. 504-509. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:313558
    Summary
    Purpose: To describe a new catheter for the percutaneous mechanical removal of fresh and organized thrombi, and to assess its efficacy and safety in vitro and in vivo. Methods: The catheter consists of a coated stainless steel spiral that rotates at 40,000 rpm over a guidewire inside the whole length of an 8 Fr, single-lumen, polyurethane catheter, driving a dual-blade cutting crown. Abraded occlusion material is sucked into the catheter head through distal side holes and transported by the spiral into a reservoir at the proximal end. The efficacy of the device was tested in arterial models and fresh bovine carotid arteries (n=72). In a clinical pilot study 10 patients (8 women, 2 men; mean age 70.6 ±10.1 years) with occlusions of the superficial femoral artery (2-12 cm, mean 5.8 cm), not older than 4 weeks, underwent thrombectomy with the new catheter. Results: In arterial models and bovine cadaver arteries the catheter completely removed fresh thrombi. Occlusion material of higher consistency was cut into particles of 100-500 μm and transported outside. Thrombectomy was successful and vessel patency restored in all 10 patients. The ankle/brachial pressure index significantly (p<0.0005) increased from 0.41±0.18 before intervention to 0.88±0.15 after 48 hr and to 0.84±0.20 after 3 months. Two reocclusions occurred within 14 days after the intervention. Conclusion: Thrombectomy with the new device appears to be feasible and safe in patients with acute and subacute occlusions of the femoropopliteal artery