Percutaneous balloon-assisted thrombectomy: preliminary in vivo results with an expandable vascular sheath system.

Abstract

To test an expandable vascular sheath system for percutaneous transcatheter balloon-assisted thrombectomy in vivo. A 9-F expandable vascular sheath system was used. The system consisted of a sheath with a deployable funnel configuration and a 3-F balloon catheter used coaxially. Thrombus was created in the inferior vena cava of 24 rabbits. Thrombus with a mean weight +/- 1 standard deviation of 1,028 mg +/- 67 was removed percutaneously with the expandable sheath system at 2 days (n = 16) and 7 days (n = 8) after formation; 7-day patency was examined after removal of 2-day-old thrombus (n = 8). Histologic examination was performed in the inferior vena cava. In all cases of 2-day-old occlusion, complete patency of the inferior vena cava was achieved. In cases of 7-day-old occlusion, patency could be completely restored in four (50%) cases; in two (25%) cases each, there was partial removal or no thrombus could be extracted. Histologic findings were comparable with those observed after balloon embolectomy. Percutaneous transcatheter balloon-assisted embolectomy is feasible with the expandable vascular sheath system.