Acute massive pulmonary embolism: use of a rotatable pigtail catheter for diagnosis and fragmentation therapy.

Abstract

Rapid partial recanalization was achieved with relative ease of instrumentation. The technique is an extension of the commonly performed pigtail catheterization of the pulmonary arteries, which may increase its clinical acceptance.

Fragmentation of massive pulmonary embolism by pigtail rotation catheter: possible complication

“…As medical thrombolysis was relatively contraindicated because of the pelvic fractures, the decision was made to treat first by catheter fragmentation using the pigtail rotation catheter (William Cook Europe, Denmark) [8,9,10], in order to perform thrombolysis subsequently with reduced dose. The predominant right pulmonary artery was catheterized.…”

Massive Pulmonary Embolism: Treatment with Thrombus Fragmentation and Local Fibrinolysis with Recombinant Human-Tissue Plasminogen Activator

“…Thrombus fragmentation can be achieved using a guidewire, a pigtail catheter, and a balloon catheter. Further developments such as a rotatable pigtail catheter, the Amplatz rotational catheter, or high-pressure jet thrombolysis show promise for clot fragmentation and have been proven effective in animals and in some patients [14][15][16][17][18].…”

Catheter-Assisted Pulmonary Embolectomy

“…This concept was first tested by Brady et al in 1991 11 who successfully used standard coronary catheters to fragment proximal thrombus in 3 patients with massive PE. An alternative technique described by SchmitzRode et al 12 involves manual spinning of an angiographic pigtail catheter in the main PA. A long, 80-to-90 cm sheath resting in the proximal PA facilitates advancement of a 100-to 125-cm pigtail catheter over a wire exiting through its proximal side-hole. The shape of the curly pigtail is thus retained as the catheter rotates on a wire like a propeller, churning the thrombus into smaller pieces.…”