The Hemolysis Effect of Rotary Cutting Thrombectomy Device: The CFD and Experimental Study

2020 ◽  
Author(s):  
Xuelian Gu ◽  
Xiaoying Zhang ◽  
Xiaojian Qiu ◽  
Kang Zheng ◽  
Licheng Lu
Keyword(s):  
Mechanical Thrombectomy ◽  
Rotation Speed ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Thrombectomy Device ◽  
Computational Fluid Dynamics Cfd ◽  
Rotary Cutting ◽  
Simulation Results ◽  
Deep Vein ◽  
Hemolysis Rate

Abstract Percutaneous mechanical thrombectomy (PMT) is an efficient way to treat the deep vein thrombosis (DVT). During the course of treatment, blood cell will be destroyed by the component of thrombectomy device, causing hemolysis. In this research, the computational fluid dynamics (CFD) methodology is used to investigate hemolysis effect of rotary cutting thrombectomy device. And a prototype of rotary cutting thrombectomy device is made to carry out two corresponding experiments to verify the simulation results. CFD results indicate that the hemolysis rate increases significantly with the rise of rotation speed of cutting component. The experimental results are in good consistence with the CFD results, and shows that the longer the working time, the higher the hemolysis rate. Thus a rotation speed between 5,000 rpm and 10,000 rpm can be considered reasonable. The results can be served as a helpful guidance for the design of such thrombectomy devices.

Trellis Thrombectomy System for the Treatment of Iliofemoral Deep Venous Thrombosis

2003 ◽  
Vol 10 (3) ◽  
pp. 585-589 ◽  
Author(s):  
Venkatesh Ramaiah ◽  
Peter B. Del Santo ◽  
Julio A. Rodriguez-Lopez ◽  
Ramesh G. Gowda ◽  
Paul E. Perkowski ◽  
...  
Keyword(s):  
Low Dose ◽  
Mechanical Thrombectomy ◽  
Heparin Therapy ◽  
Clot Lysis ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
System A ◽  
Catheter Directed Thrombolysis ◽  
Thrombectomy Device ◽  
Deep Vein

Purpose: To describe the use of a new percutaneous mechanical thrombectomy device to clear thrombus from the iliofemoral vein. Case Report: A 52-year-old woman with non-Hodgkin's lymphoma presented to the emergency room with a posterior tibial vein deep vein thrombosis and a greater saphenous vein thrombosis. Heparin therapy caused the clot to propagate into the iliofemoral vein. Catheter-directed thrombolysis for 36 hours with 24 units of reteplase failed to clear the clot. The Trellis Thrombectomy System, a new percutaneous mechanical thrombectomy device, was used to deliver a low dose of reteplase into the clot. Complete clot lysis was achieved in 45 minutes using only 5 units of reteplase. The patient's symptoms resolved completely, and she continues to be asymptomatic at 6 months with no evidence of residual clot on duplex scans. Conclusions: The Trellis device may be used to rapidly clear thrombus from the iliofemoral vein with a low dose of thrombolytic agent.

scholarly journals Single-Session Percutaneous Mechanical Thrombectomy Using the Aspirex®S Device Plus Stenting for Acute Iliofemoral Deep Vein Thrombosis: Safety, Efficacy, and Mid-Term Outcomes

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 544
Author(s):  
Romaric Loffroy ◽  
Nicolas Falvo ◽  
Kévin Guillen ◽  
Christophe Galland ◽  
Xavier Baudot ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Mechanical Thrombectomy ◽  
Therapeutic Option ◽  
Single Session ◽  
Stent Patency ◽  
Fluid Removal ◽  
Venous Stenting ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Deep Vein

To assess the safety, efficacy and mid-term outcomes of single-session percutaneous mechanical thrombectomy (PMT) for acute symptomatic iliofemoral deep vein thrombosis (DVT) using the Aspirex®S device. Retrospective review of 30 patients (women, 23; mean age, 45.5 ± 19.9 years; range, 17–76) who underwent PMT with the 10-French Aspirex®S device (Straub Medical AG, Wangs, Switzerland) for acute DVT between December 2015 and March 2019. Procedures were performed by popliteal (n = 22) or jugular (n = 7) approach, or both (n = 1). Mean time from diagnosis to PMT was 5.5 ± 4.6 days (range, 2–11). Successful thrombus removal and venous patency restoration were achieved in all patients (100%). Fluid removal was 307.8 ± 66.1 mL (range, 190–410). Additional venous stenting rate was 100%. Mean procedural time was 107.3 ± 33.9 min (range, 70–180). No major complication occurred. The patient’s postprocedural course was uneventful in all cases, with hospital discharge within 2 days in 83.3%. Early in-stent rethrombosis occurred within 1 week in 3 patients, successfully managed by endovascular approach. Secondary stent patency rate was 86.7% at a mean follow-up of 22.3 ± 14.2 months (range, 6–48), as assessed by Duplex ultrasound. Single-session of PMT using the Aspirex®S device is a safe and effective therapeutic option in patients presenting with acute symptomatic iliofemoral DVT.

Comparison of catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy for subacute iliofemoral deep vein thrombosis

2020 ◽  
Vol 35 (8) ◽  
pp. 589-596
Author(s):  
Yi-Ding Xu ◽  
Bin-Yan Zhong ◽  
Chao Yang ◽  
Xu-Sheng Cai ◽  
Bo Hu ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Mechanical Thrombectomy ◽  
Primary Patency ◽  
Efficacy Rate ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Catheter Directed Thrombolysis ◽  
Primary Endpoints ◽  
Deep Vein

Objective To evaluate and compare the treatment efficacy and safety between catheter-directed thrombolysis monotherapy and catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy for patients with subacute iliofemoral deep vein thrombosis. Methods We conducted a retrospective analysis of a total of 74 subacute iliofemoral deep vein thrombosis patients who underwent catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy. Patients treated with catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy (percutaneous mechanical thrombectomy group, n = 30) or catheter-directed thrombolysis monotherapy (catheter-directed thrombolysis group, n = 44) were included. The primary endpoints were the clinical efficacy rate of thrombolysis, primary patency, and the incidence of post-thrombotic syndrome (at 12 months diagnosed according to the original Villalta score criteria. Secondary endpoints were the total urokinase dose, the thrombolysis time, the detumescence rate and complications. Results The percentage of successful thrombolysis for percutaneous mechanical thrombectomy group was higher than that for catheter-directed thrombolysis group ( P = 0.045). At the 12-month follow-up, there was no difference in the primary patency ( P > 0.05) or the incidence of post-thrombotic syndrome ( P = 0.36). Percutaneous mechanical thrombectomy group had significant advantages in reducing urokinase doses and thrombolysis times compared with catheter-directed thrombolysis group for patients with thrombus clearance levels II and III ( P < 0.05). Conclusion Catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy performs better in removing vein thrombi, reducing urokinase doses, and shortening thrombolysis times.

scholarly journals Endovascular mechanical thrombectomy versus thrombolysis in patients with iliofemoral deep vein thrombosis – a systematic review and meta-analysis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 59-67
Author(s):  
Michael K. W. Lichtenberg ◽  
Stefan Stahlhoff ◽  
Katarzyna Młyńczak ◽  
Dominik Golicki ◽  
Paul Gagne ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Major Bleeding ◽  
Mechanical Thrombectomy ◽  
Meta Analysis ◽  
Primary Patency ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Endovascular Mechanical Thrombectomy

Summary: Background: This study sought to compare effectiveness and safety of percutaneous mechanical thrombectomy (PMT) and thrombolysis alone (THR) in patients with acute or subacute iliofemoral deep vein thrombosis (IfDVT). Patients and methods: Observational and randomized trials, published between January 2001 to February 2019 were identified by searching MEDLINE. Studies on deep venous thrombosis (DVT) treated with either THR or PMT adjunctive to conventional anticoagulation and compressive intervention were included. Meta-analysis of proportions was conducted to assess effectiveness outcomes of successful lysis and primary patency, post-thrombotic syndrome (PTS), valvular reflux, recurrent DVT, as well as safety outcomes of major bleeding, hematuria, and pulmonary embolism. Results: Of 77 identified records, 17 studies including 1417 patients were eligible. Pooled proportion of successful lysis was similar between groups (THR: 95 % [I2 = 68.4 %], PMT 96 %, [I2 = 0 %]; Qbet [Cochran’s Q between groups] 0.3, p = 0.61). However, pooled proportion of 6-month primary patency was lower after THR than after PMT (68 % [I2 = 15.6 %] versus 94 %; Qbet 26.4, p < 0.001). Considerable heterogeneity within groups did not allow for between-group comparison of PTS and recurrent DVT. Major bleeding was more frequent after THR than after PMT (6.0 % [I2 = 0 %] versus 1.0 % [I2 = 0 %]; Qbet 12.3, p < 0.001). Incidence of hematuria was lower after THR as compared to PMT (2 % [I2 = 56 %] versus 91.3 % [I2 = 91.7 %]; Qbet 714, p < 0.001). Incidences of valvular reflux and pulmonary embolism were similar across groups (THR: 61 % versus PMT: 53 %; Qbet 0.7, p = 0.39 and THR: 2 % versus PMT: 1 %; Qbet 1.1, p = 0.30, respectively). Conclusions: In patients with iliofemoral DVT, percutaneous mechanical thrombectomy was associated with a higher cumulative 6-month primary patency and a lower incidence of major bleeding compared to thrombolysis alone. Risk of hemolysis from mechanical thrombectomy needs further consideration.

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