Self-contained, Coaxial Delivery System for Intraarterial Infusion of Thrombolytic Agents

Abstract

To facilitate continued direct intrathrombus infusion of a thrombolytic agent and yet minimize catheter exchanges and manipulations, the authors developed a simple, self-contained delivery system. It involves the use of supplies available in most angiographic suites. The system has been used in 44 patients; there have been no infectious complications, and it has been well tolerated by the patients.

Local Intraarterial Thrombolysis: In Vitro Comparison of Various Infusion Catheters

“…Local infusion of thrombolytic agents into an intravascular thrombus has resulted in higher success rates and fewer complications compared with their systemic administration [1,2,10]. Originally described by Dotter et al in 1974 [11], a straight endhole catheter was introduced into the proximal portion of a thrombus and a fibrinolytic agent was infused continuously.…”

“…Originally described by Dotter et al in 1974 [11], a straight endhole catheter was introduced into the proximal portion of a thrombus and a fibrinolytic agent was infused continuously. As thrombolysis progressed, the tip of the infusion catheter was advanced stepwise to maintain delivery of the thrombolytic agent directly into the thrombus [1]. Many efforts were made to reduce catheter manipulations and to accelerate thrombolysis, resulting in a variety of infusion catheter designs with different calibers, single or multiple lumens, and arrangement of sideholes (with or without endhole occlusion).…”

“…bolytic drugs [1,2]. Persistent problems of local intraarterial thrombolysis include significant failure rates, prolonged infusion times, hemorrhagic complications, early rethrombosis, and distal embolism [3][4][5][6].…”