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Experimental impeller fragmentation of iliocaval thrombosis under tulip filter protection: preliminary results.

Abstract：

PURPOSE:To assess the efficacy of catheter fragmentation of massive caval thrombosis and of filter protection against procedure-related pulmonary embolism. METHODS:In 10 sheep, a self-expanding tulip-shaped filter made from Wallstent mesh (diameter 25 mm) was introduced from the right jugular approach into the proximal inferior vena cava. Experimentally induced massive iliocaval thrombosis was fragmented by an impeller catheter (expanded diameter 14 mm), which was advanced coaxially through the sheath of the expanded filter. Post-procedural cavography and pulmonary angiography were performed to document the extent of caval recanalization and pulmonary embolism. RESULTS:In all cases, impeller fragmentation cleared the inferior vena cava and the iliac veins of thrombi completely. Fragments washed downstream were trapped in the filter. In two of the first cases, parts of the clots caused pulmonary embolism before the filter was in place. Further events were avoided by a modification of the experimental setup. Except for some small peripheral perfusion defects in two cases, pulmonary angiograms did not show any incidence of pulmonary embolism. CONCLUSION:Our preliminary results suggest that impeller fragmentation of iliocaval thrombi under tulip filter protection is effective and does not cause significant pulmonary embolism.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

Schmitz-Rode T,Vorwerk D,Schürmann K,Günther RW

doi

10.1007/BF02577646

subject

Has Abstract

pub_date

1996-07-01 00:00:00

pages

260-4

issue

4

eissn

0174-1551

issn

1432-086X

journal_volume

19

pub_type

杂志文章

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