In Vitro Effectiveness Study of Three Hydrodynamic Thrombectomy Devices

Müller‐Hülsbeck, Stefan; Bangard, Christopher; Schwarzenberg, H.; Glüer, Claus C.; Heller, Martin

doi:10.1148/radiology.211.2.r99ma06433

Cited by 36 publications

(13 citation statements)

References 28 publications

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“…The aspiration times obtained in the current study ranged from a few seconds to a few minutes, depending on viscosity and aspiration pressure. These values are in accordance with the literature, although the only reported data found refer to a different condition (12,23).…”

Section: Discussionsupporting

confidence: 92%

Possible Benefits of Catheters With Lateral Holes in Coronary Thrombus Aspiration: A Computational Study for Different Clot Viscosities and Vacuum Pressures

2014

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According to a number of clinical studies, coronary aspiration catheters are useful tools to remove a thrombus (blood clot) blocking a coronary artery. However, these thrombectomy devices may fail to remove the blood clot entirely. Few studies have been devoted to a systematic analysis of factors affecting clot aspiration. The geometric characteristics of the aspiration catheter, the physical properties of the thrombus, and the applied vacuum pressure are crucial parameters. In this study, the aspiration of a blood clot blocking a coronary bifurcation is computationally simulated. The clot is modeled as a highly viscous fluid, and a two-phase (blood and clot) problem is solved. The effects of geometric variations in the tip of the coronary catheter, including lateral hole size and location, are investigated considering different aspiration pressures and clot viscosities. A Bird-Carreau model is adopted for blood viscosity, while a power law model is used to describe the clot rheology. Computational results for blood clot aspiration show that the presence of holes in the lateral part of the tip of the catheter can be beneficial depending on clot viscosity, hole features, and applied aspiration pressure. In general, the holes are beneficial when the clot viscosity is low, while aspiration catheters without any extra lateral holes exhibit better performance for higher clot viscosity. However, when higher aspiration pressures are applied, the catheters tend to behave relatively similarly in removing clots with various viscosities, reducing the role of the clot viscosity.

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Section: Discussionsupporting

confidence: 92%

Possible Benefits of Catheters With Lateral Holes in Coronary Thrombus Aspiration: A Computational Study for Different Clot Viscosities and Vacuum Pressures

2014

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“…Using the Bernoulli principle, the AngioJet mechanical thrombectomy catheter allows for thromboaspiration by creating a vacuum using high-pressure saline jets 9 18. Chow et al 16 first described the combination of AngioJet rheolytic therapy with low-dose intra-arterial urokinase in two patients.…”

Section: Discussionmentioning

confidence: 99%

Solitaire FR device for treatment of dural sinus thrombosis

et al. 2012

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Dural venous sinus thrombosis is a rare and potentially devastating disease. Several predisposing factors exist, including oral contraceptive therapy and colitis. First-line therapy consists of systemic anticoagulation. If first-line therapies fail, more aggressive endovascular therapies may be performed. We report our initial experience with the Solitaire FR device for treatment of refractory symptomatic dural venous sinus thrombosis.

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“…Based on the Bernoulli principle, a vacuum is created to fragment and aspirate the thrombus through the catheter. 31 Use of the device has been reported in the treatment of occluded coronary arteries in myocardial infarction, 34,35 saphenous vein grafts obstructed by atherosclerosis and thrombus, 36 acute limb ischemia, 36,37 pulmonary embolism, and in combination with stents in coronary arteries. 38 The application of the AngioJet catheter to the treatment of dural sinus thrombosis has many potential benefits.…”

Section: Discussionmentioning

confidence: 99%

“…The AngioJet is a mechanical thrombectomy catheter that works by creating a vacuum to fragment and aspirate the thrombus through the catheter (Figure 1). 31 This device has been used for many indications in peripheral interventional radiology, and its use in dural sinus thrombosis has been described in 2 patients 32,33 with associated intrasinus thrombolysis in 1 patient. 33 In the 2 cases of dural sinus thrombosis that we describe here, both patients had severe neurological symptoms despite heparin therapy and had evidence of intracranial hemorrhage on brain imaging.…”

mentioning

confidence: 99%

Endovascular Treatment of Dural Sinus Thrombosis With Rheolytic Thrombectomy and Intra-Arterial Thrombolysis

Chow

Gobin

Saver

et al. 2000

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154

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Background and Purpose-Cerebral venous thrombosis is a rare entity that can be difficult to manage. Intrasinus thrombolysis is an increasingly applied intervention, but this modality carries an increased risk of hemorrhage. We describe for the first time an option with a potentially lower incidence of intracranial bleeding, the combination of the AngioJet rheolytic thrombectomy catheter with intra-arterial thrombolysis, in 2 patients with extensive dural sinus thromboses, preexisting intracranial hemorrhage, and severe progressive neurological deficits despite heparin therapy. Methods-Four procedures were performed in 2 patients with thromboses in the superior sagittal and transverse sinuses (right in 1 patient and bilateral in 1 patient) and cortical veins. Rheolytic thrombectomy was performed in the sigmoid, transverse, straight, and superior sagittal sinuses; this technique involves the use of the Bernoulli effect to create a vacuum that fragments and aspirates thrombus. For associated persistent cortical vein thromboses, low-dose intra-arterial thrombolysis was used. Results-Both patients had excellent angiographic results with sinus reopening after rheolytic thrombectomy and cortical vein reopening after intra-arterial thrombolysis. Follow-up CT showed no change in 1 patient and increased preexisting intracranial hemorrhage in the other. One patient had a negative hypercoagulable workup, and the other patient had probable anti-phospholipid antibody syndrome. At 6 months, both patients had excellent clinical outcome with no neurological deficits except mild short-term memory loss in 1 patient. Conclusions-The combination of rheolytic thrombectomy with intra-arterial thrombolysis is a treatment modality that allows accelerated recanalization of occluded dural sinuses and cerebral veins with lower doses of thrombolytic agents.

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In Vitro Effectiveness Study of Three Hydrodynamic Thrombectomy Devices

Abstract: The devices showed performance differences. The SET catheter alone and with a guide wire and the HL may bear an increased risk of procedure-related anemia. In clinical applications, hydrodynamic thrombectomy might substantially reduce the need for thrombolytic therapy.

Cited by 36 publications

References 28 publications

Possible Benefits of Catheters With Lateral Holes in Coronary Thrombus Aspiration: A Computational Study for Different Clot Viscosities and Vacuum Pressures

Possible Benefits of Catheters With Lateral Holes in Coronary Thrombus Aspiration: A Computational Study for Different Clot Viscosities and Vacuum Pressures

Solitaire FR device for treatment of dural sinus thrombosis

Endovascular Treatment of Dural Sinus Thrombosis With Rheolytic Thrombectomy and Intra-Arterial Thrombolysis

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