Evaluation of a modified Arrow-Trerotola percutaneous thrombolytic device for treatment of acute pulmonary embolus in a canine model

Daniel B. Brown, John F. Cardella, Ronald Wilson, Harjit Singh, Peter Waybill

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

PURPOSE: Massive pulmonary embolus (PE) is often rapidly fatal. Surgical thrombectomy has a mortality rate as high as 74%. Multiple percutaneous methods have been tested with limited success. The purpose of this study was to evaluate the Arrow-Trerotola percutaneous thrombolytic device (PTD) for (i) the ability to clear pulmonary embolus and (ii) the effect on normal pulmonary vasculature. These were tested in a canine model. MATERIALS AND METHODS: Iatrogenic unilateral massive PEs were created in nine canines. These PEs were then treated with the PTD. The device was also activated in the normal pulmonary artery. Immediately after treatment, six animals were killed. Three animals were allowed to recover and underwent pulmonary arteriography 1 month later to evaluate pulmonary hypertension, stenosis, or occlusion; they were then killed. Autopsy specimens were evaluated for histologic evidence of acute or chronic vascular injury. RESULTS: Acutely, the PTD effectively thrombolysed the PE in all animals. Histologically, there was moderate intimal injury, but no evidence of pulmonary artery disruption. There was one device failure. One month after treatment, there was no radiographic evidence of pulmonary stenosis at device activation sites, no pulmonary hypertension, and only mild histologic evidence of scar formation. CONCLUSION: In preliminary animal testing, the PTD is safe and effective for treating large central pulmonary emboli. Human clinical trials are warranted.

Original languageEnglish (US)
Pages (from-to)733-740
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume10
Issue number6
DOIs
StatePublished - Jan 1 1999

Fingerprint

Embolism
Canidae
Equipment and Supplies
Lung
Pulmonary Valve Stenosis
Pulmonary Hypertension
Pulmonary Artery
Tunica Intima
Equipment Failure
Thrombectomy
Vascular System Injuries
Cicatrix
Autopsy
Angiography
Clinical Trials
Mortality
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{e631b28057ba44669ce59e7a5ec56c96,
title = "Evaluation of a modified Arrow-Trerotola percutaneous thrombolytic device for treatment of acute pulmonary embolus in a canine model",
abstract = "PURPOSE: Massive pulmonary embolus (PE) is often rapidly fatal. Surgical thrombectomy has a mortality rate as high as 74{\%}. Multiple percutaneous methods have been tested with limited success. The purpose of this study was to evaluate the Arrow-Trerotola percutaneous thrombolytic device (PTD) for (i) the ability to clear pulmonary embolus and (ii) the effect on normal pulmonary vasculature. These were tested in a canine model. MATERIALS AND METHODS: Iatrogenic unilateral massive PEs were created in nine canines. These PEs were then treated with the PTD. The device was also activated in the normal pulmonary artery. Immediately after treatment, six animals were killed. Three animals were allowed to recover and underwent pulmonary arteriography 1 month later to evaluate pulmonary hypertension, stenosis, or occlusion; they were then killed. Autopsy specimens were evaluated for histologic evidence of acute or chronic vascular injury. RESULTS: Acutely, the PTD effectively thrombolysed the PE in all animals. Histologically, there was moderate intimal injury, but no evidence of pulmonary artery disruption. There was one device failure. One month after treatment, there was no radiographic evidence of pulmonary stenosis at device activation sites, no pulmonary hypertension, and only mild histologic evidence of scar formation. CONCLUSION: In preliminary animal testing, the PTD is safe and effective for treating large central pulmonary emboli. Human clinical trials are warranted.",
author = "Brown, {Daniel B.} and Cardella, {John F.} and Ronald Wilson and Harjit Singh and Peter Waybill",
year = "1999",
month = "1",
day = "1",
doi = "10.1016/S1051-0443(99)70107-7",
language = "English (US)",
volume = "10",
pages = "733--740",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "6",

}

Evaluation of a modified Arrow-Trerotola percutaneous thrombolytic device for treatment of acute pulmonary embolus in a canine model. / Brown, Daniel B.; Cardella, John F.; Wilson, Ronald; Singh, Harjit; Waybill, Peter.

In: Journal of Vascular and Interventional Radiology, Vol. 10, No. 6, 01.01.1999, p. 733-740.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of a modified Arrow-Trerotola percutaneous thrombolytic device for treatment of acute pulmonary embolus in a canine model

AU - Brown, Daniel B.

AU - Cardella, John F.

AU - Wilson, Ronald

AU - Singh, Harjit

AU - Waybill, Peter

PY - 1999/1/1

Y1 - 1999/1/1

N2 - PURPOSE: Massive pulmonary embolus (PE) is often rapidly fatal. Surgical thrombectomy has a mortality rate as high as 74%. Multiple percutaneous methods have been tested with limited success. The purpose of this study was to evaluate the Arrow-Trerotola percutaneous thrombolytic device (PTD) for (i) the ability to clear pulmonary embolus and (ii) the effect on normal pulmonary vasculature. These were tested in a canine model. MATERIALS AND METHODS: Iatrogenic unilateral massive PEs were created in nine canines. These PEs were then treated with the PTD. The device was also activated in the normal pulmonary artery. Immediately after treatment, six animals were killed. Three animals were allowed to recover and underwent pulmonary arteriography 1 month later to evaluate pulmonary hypertension, stenosis, or occlusion; they were then killed. Autopsy specimens were evaluated for histologic evidence of acute or chronic vascular injury. RESULTS: Acutely, the PTD effectively thrombolysed the PE in all animals. Histologically, there was moderate intimal injury, but no evidence of pulmonary artery disruption. There was one device failure. One month after treatment, there was no radiographic evidence of pulmonary stenosis at device activation sites, no pulmonary hypertension, and only mild histologic evidence of scar formation. CONCLUSION: In preliminary animal testing, the PTD is safe and effective for treating large central pulmonary emboli. Human clinical trials are warranted.

AB - PURPOSE: Massive pulmonary embolus (PE) is often rapidly fatal. Surgical thrombectomy has a mortality rate as high as 74%. Multiple percutaneous methods have been tested with limited success. The purpose of this study was to evaluate the Arrow-Trerotola percutaneous thrombolytic device (PTD) for (i) the ability to clear pulmonary embolus and (ii) the effect on normal pulmonary vasculature. These were tested in a canine model. MATERIALS AND METHODS: Iatrogenic unilateral massive PEs were created in nine canines. These PEs were then treated with the PTD. The device was also activated in the normal pulmonary artery. Immediately after treatment, six animals were killed. Three animals were allowed to recover and underwent pulmonary arteriography 1 month later to evaluate pulmonary hypertension, stenosis, or occlusion; they were then killed. Autopsy specimens were evaluated for histologic evidence of acute or chronic vascular injury. RESULTS: Acutely, the PTD effectively thrombolysed the PE in all animals. Histologically, there was moderate intimal injury, but no evidence of pulmonary artery disruption. There was one device failure. One month after treatment, there was no radiographic evidence of pulmonary stenosis at device activation sites, no pulmonary hypertension, and only mild histologic evidence of scar formation. CONCLUSION: In preliminary animal testing, the PTD is safe and effective for treating large central pulmonary emboli. Human clinical trials are warranted.

UR - http://www.scopus.com/inward/record.url?scp=0033022231&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033022231&partnerID=8YFLogxK

U2 - 10.1016/S1051-0443(99)70107-7

DO - 10.1016/S1051-0443(99)70107-7

M3 - Article

C2 - 10392940

AN - SCOPUS:0033022231

VL - 10

SP - 733

EP - 740

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 6

ER -