Journal article
Acute and Delayed Outcomes of Mechanical Thrombectomy with Use of the Steerable Amplatz Thrombectomy Device in a Model of Subacute Inferior Vena Cava Thrombosis
Journal of vascular and interventional radiology, Vol.8(6), pp.947-956
1997
DOI: 10.1016/S1051-0443(97)70692-4
PMID: 9399463
Abstract
To study the efficacy and delayed outcome of mechanical thrombectomy with the Amplatz thrombectomy device (ATD) in an experimental model of subacute inferior vena cava (IVC) thrombosis.
Mechanical thrombectomy was performed in 23 dogs with subacute infrarenal IVC thrombosis (6–15 days old). Heparin was administered during thrombectomy in all procedures (activated clotting time > 300 sec). Thirteen animals were killed immediately after thrombectomy, and the remaining 10 were allowed to survive for up to 1 month with no anticoagulation therapy.
Venographic patency of the IVC was restored in all animals, although residual mural thrombus remained in nine dogs (< 20% narrowing in seven, 20%–30% narrowing in two). No histopathologic evidence of mechanical wall disruption attributed to mechanical thrombectomy was seen. However, foci of organizing residual thrombus with associated transmural phlebitic changes with round-cellular infiltration were present in all acute specimens, including those appearing clear at venography. Venography at 1 week or 1 month after thrombectomy showed IVC rethrombosis in eight dogs (80%) who were not receiving anticoagulants. During mechanical thrombectomy, a small increase in mean pulmonary artery pressure occurred, with a corresponding decrease in systemic arterial oxygen saturation. No acute emboli were noted on the post-thrombectomy pulmonary angiograms. However, histopathologic examination of acutely explanted lungs in 11 animals showed arteriolar microemboli (100–500
μm) in four.
Mechanical thrombectomy with use of the ATD can effectively clear subacute IVC thrombus. However, rethrombosis is common and may be due to the high prevalence of phlebitis and residual thrombus. Anticoagulation may need to be continued after successful thrombectomy to prevent progression of residual thrombus and allow mural phlebitic changes to subside.
Details
- Title: Subtitle
- Acute and Delayed Outcomes of Mechanical Thrombectomy with Use of the Steerable Amplatz Thrombectomy Device in a Model of Subacute Inferior Vena Cava Thrombosis
- Creators
- Xiaoping GuMelhem J.A SharafuddinJack L TitusMyra UrnessJose J Cervera-CeballosGregory D RuthKurt Amplatz
- Resource Type
- Journal article
- Publication Details
- Journal of vascular and interventional radiology, Vol.8(6), pp.947-956
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S1051-0443(97)70692-4
- PMID
- 9399463
- ISSN
- 1051-0443
- eISSN
- 1535-7732
- Language
- English
- Date published
- 1997
- Academic Unit
- Radiology; Surgery
- Record Identifier
- 9984051986902771
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