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Titolo:
The effects of a mechanical thrombolytic device on normal canine vein valves
Autore:
McLennan, G; Trerotola, SO; Davidson, D; Rhodes, CA; Lazzaro, C; Dreesen, J; Tennery, G; Lane, KA;
Indirizzi:
Indiana Univ, Sch Med, Dept Radiol, Indianapolis, IN 46202 USA Indiana Univ Indianapolis IN USA 46202 Radiol, Indianapolis, IN 46202 USA Indiana Univ, Sch Med, Dept Pathol, Indianapolis, IN 46202 USA Indiana Univ Indianapolis IN USA 46202 Pathol, Indianapolis, IN 46202 USA Indiana Univ, Sch Med, Dept Med, Indianapolis, IN USA Indiana Univ Indianapolis IN USA Sch Med, Dept Med, Indianapolis, IN USA
Titolo Testata:
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
fascicolo: 1, volume: 12, anno: 2001,
pagine: 89 - 94
SICI:
1051-0443(200101)12:1<89:TEOAMT>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
AMPLATZ THROMBECTOMY DEVICE; DEEP VENOUS THROMBOSIS; POSTTHROMBOTIC-SYNDROME; THERAPY; EPISODE; SYSTEM;
Keywords:
thrombolysis, mechanical; thrombosis, venous; veins, valves;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: McLennan, G Indiana Univ Hosp, Dept Radiol, Room 0279,550 N Univ Blvd, Indianapolis, IN 46202 USA Indiana Univ Hosp Room 0279,550 N Univ Blvd Indianapolis IN USA 46202
Citazione:
G. McLennan et al., "The effects of a mechanical thrombolytic device on normal canine vein valves", J VAS INT R, 12(1), 2001, pp. 89-94

Abstract

PURPOSE: To determine if the Arrow-Trerotola Percutaneous Thrombolytic Device (PTD) causes damage to normal vein valves. MATERIALS AND METHODS: Ten lateral saphenous veins in five dogs were studied with descending venography with use of a wedge balloon catheter positioned above 48 valves (demonstrating 51 valves) before and after five antegrade passes each with an over-the-wire (0.025-inch), 6.5-F, 9-mm-diameter PTD. Vein diameters were 3.2-11.4 mm (mean, 5.9 mm). Contrast matter was injected at incremental rates from 3 to 15 mL/min during continuous pressure monitoring. Imaging was performed with digital subtraction angiography at a rate of 1 frame/sec. The time to valve reflux was determined by noting the frame at which reflux was first seen through the valve. The time to reflux andpressure required to reflux were compared before and after the PTD passes. All vessels were explanted and evaluated histologically for presence or absence of endothelial loss, thrombus formation, inflammation, or valve degeneration. Four veins in two animals were studied with venography to determine the variability of the venographic method. These veins thrombosed during venography and therefore served as positive pathologic controls. In two animals, one vein was studied with venography and one was not studied to provide pathologic controls. RESULTS: With use of two physiologic tests of valve function, 77% of valves had minimal or no damage as assessed by valve competency and 80% had minimal or no damage as demonstrated by the change in the pressures the valve can withstand before reflux. Twenty-six of 51 valves (51%) had no differenceor later reflux after PTD use. Thirteen (26%) refluxed 1 second earlier after PTD use and 12 (23%) refluxed greater than or equal to2 seconds earlier(six at 2, four at 3, and two at 4). Four of the six valves with more thana 2-second difference in reflux times were in valves with diameters less than 4.2 mm. All these vessels were smaller than 7 mm in diameter. Twenty-one of 48 valve levels (44%) had no difference or sustained higher pressures before reflux after PTD use. Seventeen (36%) had a pressure drop of <10 mm Hg; five (10%) had drops of 12-24 mm Hg; and five (10%) had drops of more than 40 mm Hg. There was a significant difference in endothelial loss, thrombus formation, and inflammation between experimental veins, the veins with thrombus, the venography controls, and the normal vein controls. There was significant difference only in terms of inflammation when the experimental group was compared to the thrombosis group. CONCLUSION: The antegrade use of the PTD across normal canine vein valves does not cause physiologically significant damage in valves 7 mm or larger in diameter in this animal model.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 07:58:36