Minko P, Bücker A, Laschke M, Menger M, Bohle R, Katoh M
Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany,
Cardiovasc Intervent Radiol. 2014 Feb;37(1):211-7. doi: 10.1007/s00270-013-0661-8. Epub 2013 Jun 8.
To investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model.
Iliac vein thrombosis was induced in six pigs by means of an occlusion-balloon catheter and thrombin injection. The presence of thrombi was verified by digital subtraction angiography (DSA) and computed tomography (CT). Thrombectomy was performed using 6F and 8F Rotarex and 6F, 8F, and 10F Aspirex catheters (Straub Medical AG, Wangs, Switzerland). After intervention, DSA and CT were repeated to evaluate the efficacy of mechanical thrombectomy and to exclude local complications. In addition, pulmonary CT was performed to rule out pulmonary embolism. Finally, all pigs were killed, and iliac veins were dissected to perform macroscopic and histological examination.
Thrombus induction was successfully achieved in all animals as verified by DSA and CT. Subsequent thrombectomy lead to incomplete recanalization of the iliac veins with residual thrombi in all cases. However, the use of the 6F and 8F Rotarex catheters caused vessel perforation and retroperitoneal hemorrhage in all cases. Application of the Aspirex device caused one small transmural perforation in a vessel treated with a 10F Aspirex catheter, and this was only seen microscopically. Pulmonary embolism was detected in one animal treated with the Rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the Aspirex catheters.
The Aspirex catheter allowed subtotal and safe recanalization of iliac vein thrombosis. In contrast, the use of the Rotarex catheter caused macroscopically obvious vessel perforations in all cases.
在猪模型中研究使用Rotarex和Aspirex导管进行机械性血栓切除术治疗髂静脉血栓形成的有效性和安全性。
通过闭塞球囊导管和注射凝血酶在6头猪中诱导髂静脉血栓形成。通过数字减影血管造影（DSA）和计算机断层扫描（CT）证实血栓的存在。使用6F和8F Rotarex导管以及6F、8F和10F Aspirex导管（瑞士旺斯的Straub Medical AG公司）进行血栓切除术。干预后，重复进行DSA和CT以评估机械性血栓切除术的有效性并排除局部并发症。此外，进行肺部CT以排除肺栓塞。最后，处死所有猪，解剖髂静脉以进行大体和组织学检查。
经DSA和CT证实，所有动物均成功诱导出血栓。随后的血栓切除术导致所有病例中髂静脉再通不完全，均有残余血栓。然而，使用6F和8F Rotarex导管在所有病例中均导致血管穿孔和腹膜后出血。使用Aspirex装置在1例接受10F Aspirex导管治疗的血管中引起1处小的全层穿孔，且仅在显微镜下可见。在用Rotarex导管治疗的1只动物中检测到肺栓塞，而在用Aspirex导管治疗的动物中未见到肺栓塞。
Aspirex导管可实现髂静脉血栓形成的次全和安全再通。相比之下，使用Rotarex导管在所有病例中均导致肉眼可见的明显血管穿孔。
