Comparison of a new recirculation thrombectomy catheter with other devices of the same type

In vitro and in vivo evaluations

Zhong Qian, Peter Kvamme, Dina Raghed, Manuel Maynar, John Hamide, William D. Scheer, Carmen Espinoza, Beatriz Loscertales, Wilfrido R. Castañeda

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

RATIONALE AND OBJECTIVES. To compare a new 7 Fr. Helix thrombectomy catheter with Amplatz thrombectomy devices (ATD) with respect to clot fragmentation efficiency, hemolytic potential, and risk for vascular trauma. MATERIALS AND METHODS. Particle size was evaluated following the maceration of 8-to-10-day-old clots, each weighing 6 ± 0.01 g. The clots were macerated using devices of various sizes, including the 7-Fr. Helix thrombectomy catheter, the 7-Fr. over-the-wire (OTW), 8-Fr. ATD and the 6-Fr. ATD. The number of particles by weight was quantified. The 7-Fr. Helix and the 8-Fr. ATD were tested in the native iliac vein of six dogs without presence of clots. Blood samples were obtained before, during, and at 1, 3, 6, 24, and 48 hours after the procedure, to monitor the hemolytic effects. The treated iliac veins were examined histologically. RESULTS. Most of the clot was fragmented into particles <10 μm. The mean percentage by weight of the original clot that remained as particles larger than10 μm was 1.59% in the 7-Fr. Helix group. This was significantly less than 3.10% with the 6-Fr. ATD, 2.57% with 7-Fr. OTW and 2.44% in the 8-Fr. ATD group (<0.01). In vivo results showed a higher plasma free hemoglobin (PFH) level starting 5 minutes after initiating the ATD activation, reaching its peak after completion of the activation, and declining afterward, with return to the baseline at 24 hours. The haptoglobin level tended to decline slightly at 10 minutes, reaching its lowest level at 24 hours, and starting to recover at 48 hours. A similar pattern of PFH and haptoglobin changes was found in both groups. There were no significant differences regarding hemolytic effect of the two tested devices. No significant changes of creatinine were observed for up to 48 hours after procedures. Focal microthrombosis was seen in two sites of two vessels treated with the 7-Fr. Helix and a focal injury of a venous valve was noted in the 8-Fr. ATD group. The media and internal elastic lamina (IEL) were intact in all cases. CONCLUSION. The newly designed 7-Fr. Helix is more effective in fragmentation in vitro clots than the 6 Fr. ATD, 7-Fr. OTW and the 8-Fr. ATD. The 7-Fr. Helix and the 8-Fr. ATD produced hemolytic effects, but they appeared to be tolerated by the animals. The in vivo results indicated that the 7-Fr. Helix appears to be as safe as the 8-Fr. ATD.

Original languageEnglish (US)
Pages (from-to)503-511
Number of pages9
JournalInvestigative Radiology
Volume37
Issue number9
DOIs
StatePublished - Sep 1 2002
Externally publishedYes

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Thrombectomy
Catheters
Equipment and Supplies
Iliac Vein
Haptoglobins
In Vitro Techniques
Hemoglobins
Venous Valves
Weights and Measures
Wounds and Injuries
Particle Size
Blood Vessels

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Comparison of a new recirculation thrombectomy catheter with other devices of the same type : In vitro and in vivo evaluations. / Qian, Zhong; Kvamme, Peter; Raghed, Dina; Maynar, Manuel; Hamide, John; Scheer, William D.; Espinoza, Carmen; Loscertales, Beatriz; Castañeda, Wilfrido R.

In: Investigative Radiology, Vol. 37, No. 9, 01.09.2002, p. 503-511.

Research output: Contribution to journalArticle

Qian, Z, Kvamme, P, Raghed, D, Maynar, M, Hamide, J, Scheer, WD, Espinoza, C, Loscertales, B & Castañeda, WR 2002, 'Comparison of a new recirculation thrombectomy catheter with other devices of the same type: In vitro and in vivo evaluations', Investigative Radiology, vol. 37, no. 9, pp. 503-511. https://doi.org/10.1097/00004424-200209000-00005
Qian, Zhong ; Kvamme, Peter ; Raghed, Dina ; Maynar, Manuel ; Hamide, John ; Scheer, William D. ; Espinoza, Carmen ; Loscertales, Beatriz ; Castañeda, Wilfrido R. / Comparison of a new recirculation thrombectomy catheter with other devices of the same type : In vitro and in vivo evaluations. In: Investigative Radiology. 2002 ; Vol. 37, No. 9. pp. 503-511.
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abstract = "RATIONALE AND OBJECTIVES. To compare a new 7 Fr. Helix thrombectomy catheter with Amplatz thrombectomy devices (ATD) with respect to clot fragmentation efficiency, hemolytic potential, and risk for vascular trauma. MATERIALS AND METHODS. Particle size was evaluated following the maceration of 8-to-10-day-old clots, each weighing 6 ± 0.01 g. The clots were macerated using devices of various sizes, including the 7-Fr. Helix thrombectomy catheter, the 7-Fr. over-the-wire (OTW), 8-Fr. ATD and the 6-Fr. ATD. The number of particles by weight was quantified. The 7-Fr. Helix and the 8-Fr. ATD were tested in the native iliac vein of six dogs without presence of clots. Blood samples were obtained before, during, and at 1, 3, 6, 24, and 48 hours after the procedure, to monitor the hemolytic effects. The treated iliac veins were examined histologically. RESULTS. Most of the clot was fragmented into particles <10 μm. The mean percentage by weight of the original clot that remained as particles larger than10 μm was 1.59{\%} in the 7-Fr. Helix group. This was significantly less than 3.10{\%} with the 6-Fr. ATD, 2.57{\%} with 7-Fr. OTW and 2.44{\%} in the 8-Fr. ATD group (<0.01). In vivo results showed a higher plasma free hemoglobin (PFH) level starting 5 minutes after initiating the ATD activation, reaching its peak after completion of the activation, and declining afterward, with return to the baseline at 24 hours. The haptoglobin level tended to decline slightly at 10 minutes, reaching its lowest level at 24 hours, and starting to recover at 48 hours. A similar pattern of PFH and haptoglobin changes was found in both groups. There were no significant differences regarding hemolytic effect of the two tested devices. No significant changes of creatinine were observed for up to 48 hours after procedures. Focal microthrombosis was seen in two sites of two vessels treated with the 7-Fr. Helix and a focal injury of a venous valve was noted in the 8-Fr. ATD group. The media and internal elastic lamina (IEL) were intact in all cases. CONCLUSION. The newly designed 7-Fr. Helix is more effective in fragmentation in vitro clots than the 6 Fr. ATD, 7-Fr. OTW and the 8-Fr. ATD. The 7-Fr. Helix and the 8-Fr. ATD produced hemolytic effects, but they appeared to be tolerated by the animals. The in vivo results indicated that the 7-Fr. Helix appears to be as safe as the 8-Fr. ATD.",
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T1 - Comparison of a new recirculation thrombectomy catheter with other devices of the same type

T2 - In vitro and in vivo evaluations

AU - Qian, Zhong

AU - Kvamme, Peter

AU - Raghed, Dina

AU - Maynar, Manuel

AU - Hamide, John

AU - Scheer, William D.

AU - Espinoza, Carmen

AU - Loscertales, Beatriz

AU - Castañeda, Wilfrido R.

PY - 2002/9/1

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N2 - RATIONALE AND OBJECTIVES. To compare a new 7 Fr. Helix thrombectomy catheter with Amplatz thrombectomy devices (ATD) with respect to clot fragmentation efficiency, hemolytic potential, and risk for vascular trauma. MATERIALS AND METHODS. Particle size was evaluated following the maceration of 8-to-10-day-old clots, each weighing 6 ± 0.01 g. The clots were macerated using devices of various sizes, including the 7-Fr. Helix thrombectomy catheter, the 7-Fr. over-the-wire (OTW), 8-Fr. ATD and the 6-Fr. ATD. The number of particles by weight was quantified. The 7-Fr. Helix and the 8-Fr. ATD were tested in the native iliac vein of six dogs without presence of clots. Blood samples were obtained before, during, and at 1, 3, 6, 24, and 48 hours after the procedure, to monitor the hemolytic effects. The treated iliac veins were examined histologically. RESULTS. Most of the clot was fragmented into particles <10 μm. The mean percentage by weight of the original clot that remained as particles larger than10 μm was 1.59% in the 7-Fr. Helix group. This was significantly less than 3.10% with the 6-Fr. ATD, 2.57% with 7-Fr. OTW and 2.44% in the 8-Fr. ATD group (<0.01). In vivo results showed a higher plasma free hemoglobin (PFH) level starting 5 minutes after initiating the ATD activation, reaching its peak after completion of the activation, and declining afterward, with return to the baseline at 24 hours. The haptoglobin level tended to decline slightly at 10 minutes, reaching its lowest level at 24 hours, and starting to recover at 48 hours. A similar pattern of PFH and haptoglobin changes was found in both groups. There were no significant differences regarding hemolytic effect of the two tested devices. No significant changes of creatinine were observed for up to 48 hours after procedures. Focal microthrombosis was seen in two sites of two vessels treated with the 7-Fr. Helix and a focal injury of a venous valve was noted in the 8-Fr. ATD group. The media and internal elastic lamina (IEL) were intact in all cases. CONCLUSION. The newly designed 7-Fr. Helix is more effective in fragmentation in vitro clots than the 6 Fr. ATD, 7-Fr. OTW and the 8-Fr. ATD. The 7-Fr. Helix and the 8-Fr. ATD produced hemolytic effects, but they appeared to be tolerated by the animals. The in vivo results indicated that the 7-Fr. Helix appears to be as safe as the 8-Fr. ATD.

AB - RATIONALE AND OBJECTIVES. To compare a new 7 Fr. Helix thrombectomy catheter with Amplatz thrombectomy devices (ATD) with respect to clot fragmentation efficiency, hemolytic potential, and risk for vascular trauma. MATERIALS AND METHODS. Particle size was evaluated following the maceration of 8-to-10-day-old clots, each weighing 6 ± 0.01 g. The clots were macerated using devices of various sizes, including the 7-Fr. Helix thrombectomy catheter, the 7-Fr. over-the-wire (OTW), 8-Fr. ATD and the 6-Fr. ATD. The number of particles by weight was quantified. The 7-Fr. Helix and the 8-Fr. ATD were tested in the native iliac vein of six dogs without presence of clots. Blood samples were obtained before, during, and at 1, 3, 6, 24, and 48 hours after the procedure, to monitor the hemolytic effects. The treated iliac veins were examined histologically. RESULTS. Most of the clot was fragmented into particles <10 μm. The mean percentage by weight of the original clot that remained as particles larger than10 μm was 1.59% in the 7-Fr. Helix group. This was significantly less than 3.10% with the 6-Fr. ATD, 2.57% with 7-Fr. OTW and 2.44% in the 8-Fr. ATD group (<0.01). In vivo results showed a higher plasma free hemoglobin (PFH) level starting 5 minutes after initiating the ATD activation, reaching its peak after completion of the activation, and declining afterward, with return to the baseline at 24 hours. The haptoglobin level tended to decline slightly at 10 minutes, reaching its lowest level at 24 hours, and starting to recover at 48 hours. A similar pattern of PFH and haptoglobin changes was found in both groups. There were no significant differences regarding hemolytic effect of the two tested devices. No significant changes of creatinine were observed for up to 48 hours after procedures. Focal microthrombosis was seen in two sites of two vessels treated with the 7-Fr. Helix and a focal injury of a venous valve was noted in the 8-Fr. ATD group. The media and internal elastic lamina (IEL) were intact in all cases. CONCLUSION. The newly designed 7-Fr. Helix is more effective in fragmentation in vitro clots than the 6 Fr. ATD, 7-Fr. OTW and the 8-Fr. ATD. The 7-Fr. Helix and the 8-Fr. ATD produced hemolytic effects, but they appeared to be tolerated by the animals. The in vivo results indicated that the 7-Fr. Helix appears to be as safe as the 8-Fr. ATD.

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