Embolectomy Annotated Bibliography - October 2008

Lajvardi A, Trerotola SO, Strandberg JD, Samphilipo MA, Magee C. Evaluation of venous injury caused by a percutaneous mechnical thrombolytic device. Cardiovascular and Interventional Radiology. 1995 May June 18(3): 172-178.

The researchers studied the potential for venous injury caused by a prototype percutaneous mechanical thrombolytic device using a rabbit animal model. They used the mechanical thombolytic device as the test method and the Fogarty balloon catheter (FBC) as the control. Venous injury was evaluated and it was found that both techniques offered similar results with less trauma noted in the distal IVC by the mechanical thrombolytic device.

Comment: The authors identified Fogarty balloon catheter as the "gold standard" for thrombectomy.

Lazzaro CR, Trerotola SO, Shah H, et al. Modified use of the Arrow-Trerotola percutaneous thrombolytic device for the treatment of thrombosed hemodialysis access grafts. Journal of Vascular and Interventional Radiology. 1999 Sept; 10(8): 1025-1031.

The authors assessed the safety and efficacy of the Arrow-Trerotola percutaneous thrombolytic device (PTD) as the sole means of mechanical thrombolysis in hemodialysis access grafts, including in situ treatment of the arterial plug.

Comments: The authors used the embolectomy device to remove the arterial plug thereby eliminating the use of an Embolectomy catheter. There was a slight increase in embolic complications with this technique but were treated with a backbleeding technique.

Vesley TM. Mechanical thrombectomy devices to treat thrombosed hemodialysis grafts. Techniques in Vascular Interventional Radiology. 2003 Mar; 6(1):34-41.

The author reviews treatment of a thrombosed hemodialysis graft. He identifies that there are a variety of thrombectomy methods that are currently utilized by interventional radiologists, mechanical thrombectomy being just one technique. He also states that each device has its own niche and is best utilized for specific situations and that a practitioner needs to be familiar with several of these thrombectomy devices to most effectively treat the variety of clinical problems that may be encountered.

Comment: In this review he also discusses the use of an embolectomy catheter to dislodge the arterial plug; this is the final step of the thrombectomy procedure.