Published in:
01-06-2003 | Laboratory Investigations
Influence of Thrombus Age on the Mechanical Thrombectomy Efficacy
of the Amplatz Thrombectomy Device In Vitro
Authors:
Jan Grimm, Thomas Jahnke, Claus Muhle, Martin Heller, Stefan Müller-Hülsbeck
Published in:
CardioVascular and Interventional Radiology
|
Issue 3/2003
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Abstract
Purpose: To determine the efficacy of
thrombectomy for the Amplatz Thrombectomy Device (ATD) according to the
age of the thrombus.
Methods: Thrombectomy was performed
with the 7 Fr or 8 Fr ATD. Five-day-old or 8-day-old thrombi were made
from porcine blood by clotting within silicone tubes to be used in a
flow model. Emboli sizes, weight, remaining thrombus and activation
time were evaluated.
Results: The age of the thrombus
had no influence on the activation time necessary for complete
thrombolysis. A significant difference was found in the overall amount
of embolization only with the 7 Fr device although a similar trend was
shown with the 8 Fr device. The amount of embolized thrombotic material
was higher for both devices if older thrombi (i.e., 8 days old) were
processed. The overall impression was that the 8 Fr device showed
slightly better results (less remaining thrombus and embolization).
Conclusion: A tendency toward higher amounts of embolization
was observed if older thrombi were used in the model. Therefore the
interventional radiologist should be aware of the potentially higher
risk of peripheral embolization when performing mechanical thrombectomy
(with the ATD) in older thrombotic occlusions, especially since the
higher rate of embolization was mainly due to an increased proportion
of larger embolic particles (1 mm), which are clinically more
significant.