Müller-Hülsbeck S, Dimitte D N, Jahnke T, Hedderich J, Grimm J, Heller M
Klinik für Diagnostische Radiologie der Christian-Albrechts-Universität zu Kiel.
Rofo. 2003 Mar;175(3):406-12. doi: 10.1055/s-2003-37829.
To determine the in vitro effectiveness of the Amplatz and Rotarex catheters for thrombus fragmentation and combined thrombus fragmentation and aspiration.
Clots (n = 100) from 5-day-old porcine blood (8.5 g) were fragmented with the 8F Rotarex trade mark catheter (RR; 40.000 rpm), which was directed with or without a coaxial guide wire (GW 0.020 inch [8 F RR(GW)], GW 0.014 inch [6 F RR(GW)]), and with the 7 F Amplatz catheter (ATD; 150.000 rpm), in an artery flow model (pulsed flow of 700 ml/min) simulating the superficial femoral artery. To increase the wall adherence of the thrombus, an additional equal number of silicon tubes (with an inner diameter of 7 mm) were fitted inside with a metallic mesh (wall-adherent thrombus [WAT]; 6 F RR(WAT), 8 F RR(WAT), 6 F R(WAT-GW), 8 F RR(WAT-GW), ATD(WAT) ). The effluent was passed through a three-step filter system (10 to 1000 micro m; pressure gradient 35 mmHg).
Highest effectiveness was found for 8 F RR (no remaining thrombus detectable) compared to 6 F RR (0.08 g) and ATD (0.07 g), with a p < 0.001 for both methods. The aspirated volume was significantly lower when 6 F and 8 F RR were used with a coaxial guide wire (p < 0.001). The total emboli rate for 8 F RR was significantly lower compared to ATD (p < 0.001). Even when working without a guide wire, 8 F RR caused the lowest proportion of emboli (depending on the modification 0.12 % to 1.76 %; compared to all p < 0.05). Emboli rates reached 7.99 % for 6 F RR (compared to all p < 0.001) and were maximal 5.61 % for ATD.
The tested mechanical thrombectomy catheters have a high potential for in vitro thrombectomy with moderate performance differences. In contrast to the guidewire-directed Rotarex fragmentation-aspiration device, the ATD trade mark fragmentation catheter and prototype Rotarex 6 F catheter have a considerable peripheral embolization rate of particles larger than 1000 micro m, probably requiring additional measures for in vivo thrombectomy.
确定安普拉斯（Amplatz）导管和罗塔瑞克斯（Rotarex）导管在体外进行血栓破碎以及联合血栓破碎与抽吸的效果。
使用8F罗塔瑞克斯商标导管（RR；40000转/分钟）对来自5日龄猪血（8.5克）的100个凝块进行破碎，该导管在有或没有同轴导丝（0.020英寸[8F RR(GW)]、0.014英寸[6F RR(GW)]）引导的情况下，以及使用7F安普拉斯导管（ATD；150000转/分钟），在模拟股浅动脉的动脉血流模型（700毫升/分钟的脉冲血流）中进行操作。为增加血栓与血管壁的附着力，另外在相同数量的硅管（内径7毫米）内安装金属网（壁附着血栓[WAT]；6F RR(WAT)、8F RR(WAT)、6F RR(WAT - GW)、8F RR(WAT - GW)、ATD(WAT)）。流出物通过三步过滤系统（10至1000微米；压力梯度35毫米汞柱）。
与6F RR（0.08克）和ATD（0.07克）相比，8F RR的效果最佳（未检测到残留血栓），两种方法的p值均<0.001。当6F和8F RR与同轴导丝一起使用时，抽吸量显著降低（p<0.001）。8F RR的总栓子率明显低于ATD（p<0.001）。即使在没有导丝的情况下操作，8F RR产生的栓子比例也最低（根据不同变体为0.12%至1.76%；与其他所有情况相比p<0.05）。6F RR的栓子率达到7.99%（与其他所有情况相比p<0.001），ATD的最大栓子率为5.61%。
所测试的机械血栓清除导管在体外血栓清除方面具有很大潜力，性能差异适中。与导丝引导的罗塔瑞克斯破碎 - 抽吸装置相比，ATD商标破碎导管和原型罗塔瑞克斯6F导管对于大于1000微米的颗粒具有相当高的外周栓塞率，可能需要采取额外措施进行体内血栓清除。
