ABSTRACT
PURPOSE: Catheters are compared in vitro to evaluate the efficacy of thrombolysis during urokinase infusion within the thrombus. METHODS: Six catheters were introduced individually into human thrombus within a stenotic flow model. Urokinase was infused continuously into the thrombus. To quantify the efficacy of thrombolysis, pressure gradients were recorded proximal and distal to the thrombus and during the course of infusion. Uniformity of lysis was assessed radiographically. RESULTS: The fastest and most homogeneous thrombolysis was achieved with the EDM and the straight-flush catheter, shown by decreasing transthrombotic pressure gradients. All other catheter designs showed less homogeneous and delayed thrombolysis (p 0.7). CONCLUSION: The EDM catheter and the straight flush catheter achieved the most homogeneous and fastest thrombolysis, apparently due to the best urokinase distribution within the thrombus.
Subject(s)
Catheterization/instrumentation , Infusions, Intra-Arterial/instrumentation , Plasminogen Activators/administration & dosage , Thrombolytic Therapy/instrumentation , Thrombosis/drug therapy , Urokinase-Type Plasminogen Activator/administration & dosage , Equipment Design , Humans , In Vitro Techniques , Time FactorsABSTRACT
PURPOSE: Manual and automatic pulse-spray infusion techniques are compared in vitro to evaluate the efficacy of thrombolysis and the distribution of urokinase and saline solution within thrombus using a pulse-spray catheter. METHODS: A pulse-spray catheter was introduced into a human thrombus within a stenotic flow model. Automatic and manual pulsed infusion of urokinase and automatic pulsed infusion of saline solution were compared. To quantify the efficacy of thrombolysis, pressure gradients were recorded proximal and distal to the thrombus and during the course of infusion. Distribution of infused urokinase was assessed radiographically. RESULTS: The fastest and most homogeneous dissolution of the thrombus was achieved with automatic pulsed infusion of urokinase, shown by decreasing transthrombotic pressure gradients (p < 0.001, Wilcoxon, matched pairs). Manual pulsed infusion of urokinase or saline solution resulted in inhomogeneous thrombus dissolution and delayed thrombolysis. CONCLUSION: Application of automatic pulse-spray injectors seems beneficial for more effective and homogeneous intraarterial pulse-spray thrombolysis when compared with conventional manual pulsed technique.
