Rheolytic catheter for percutaneous removal of thrombus.

Abstract

The authors present a percutaneous thrombectomy system (rheolytic thrombectomy catheter [RTC]) in which high-velocity jets of saline solution are used to lyse and remove thrombus. The catheters (4-6 F) direct a 10,000-15,000-psi (0.7-1.05 x 10(5)-kPa) jet of saline solution onto an exhaust port from orifices at the end of the catheter. The jet entrains clot and resulting fragments and brings them into the high-velocity region for lysis and removal. Whole blood clots (10-15 cm) placed in 6-9-mm-diameter tubing were completely dissolved and removed with the RTC in less than 1 minute. In vivo use in a canine model resulted in lysis and removal of clots from a femoral artery, without vessel damage. The small caliber, flexibility, and effective lysis of this system suggest its potential usefulness in large central vessels that are difficult to access surgically and in small-diameter vessels that require more rapid removal of thrombus than can be achieved with thrombolytic therapy.