Pulmonary emboli from pulse-spray and mechanical thrombolysis: Evaluation with an animal dialysis-graft model

Scott O. Trerotola, Matthew S. Johnson, Donald S. Schauwecker, Darrell Davidson, Ronald S. Filo, Xiao H. Zhou, George J. Eckert, R. Gerald Dreesen, Kathy A. Carlson, Mitchell Forney

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

PURPOSE: To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts. MATERIALS AND METHODS: Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device. Perfusion imaging, pulmonary- artery pressure measurements, and pulmonary arteriography were performed before and after each procedure. RESULTS: A total of 22 procedures were performed (11 PSPMT and 11 mechanical thrombolysis). Declotting was successful in all procedures, with 100% 30-day patency. Segmental defects were seen on perfusion images after 10 (91%) of 11 PSPMT procedures and two (18%) of 11 mechanical thrombolysis procedures (P < .002). Transient increases in pulmonary-artery pressure occurred in the PSPMT group. Complete resolution of emboli and return to baseline pressures were seen in all cases, even after multiple (up to four) procedures in the same animal. There was no histologic evidence of pulmonary infarction in either group. CONCLUSION: The percutaneous thrombolytic device is effective for declotting dialysis grafts in dogs and results in statistically significantly fewer pulmonary emboli compared with PSPMT.

Original languageEnglish
Pages (from-to)169-176
Number of pages8
JournalRadiology
Volume200
Issue number1
StatePublished - Jul 1996

Fingerprint

Mechanical Thrombolysis
Embolism
Dialysis
Transplants
Lung
Pressure
Pulmonary Artery
Pulmonary Infarction
Dogs
Equipment and Supplies
Perfusion Imaging
Urokinase-Type Plasminogen Activator
Polytetrafluoroethylene
Angiography
Perfusion

Keywords

  • Dialysis, shunts
  • Embolism, pulmonary
  • Grafts, stenosis or thrombosis
  • Interventional procedures, technology

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Trerotola, S. O., Johnson, M. S., Schauwecker, D. S., Davidson, D., Filo, R. S., Zhou, X. H., ... Forney, M. (1996). Pulmonary emboli from pulse-spray and mechanical thrombolysis: Evaluation with an animal dialysis-graft model. Radiology, 200(1), 169-176.

Pulmonary emboli from pulse-spray and mechanical thrombolysis : Evaluation with an animal dialysis-graft model. / Trerotola, Scott O.; Johnson, Matthew S.; Schauwecker, Donald S.; Davidson, Darrell; Filo, Ronald S.; Zhou, Xiao H.; Eckert, George J.; Dreesen, R. Gerald; Carlson, Kathy A.; Forney, Mitchell.

In: Radiology, Vol. 200, No. 1, 07.1996, p. 169-176.

Research output: Contribution to journalArticle

Trerotola, SO, Johnson, MS, Schauwecker, DS, Davidson, D, Filo, RS, Zhou, XH, Eckert, GJ, Dreesen, RG, Carlson, KA & Forney, M 1996, 'Pulmonary emboli from pulse-spray and mechanical thrombolysis: Evaluation with an animal dialysis-graft model', Radiology, vol. 200, no. 1, pp. 169-176.
Trerotola SO, Johnson MS, Schauwecker DS, Davidson D, Filo RS, Zhou XH et al. Pulmonary emboli from pulse-spray and mechanical thrombolysis: Evaluation with an animal dialysis-graft model. Radiology. 1996 Jul;200(1):169-176.
Trerotola, Scott O. ; Johnson, Matthew S. ; Schauwecker, Donald S. ; Davidson, Darrell ; Filo, Ronald S. ; Zhou, Xiao H. ; Eckert, George J. ; Dreesen, R. Gerald ; Carlson, Kathy A. ; Forney, Mitchell. / Pulmonary emboli from pulse-spray and mechanical thrombolysis : Evaluation with an animal dialysis-graft model. In: Radiology. 1996 ; Vol. 200, No. 1. pp. 169-176.
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AU - Davidson, Darrell

AU - Filo, Ronald S.

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N2 - PURPOSE: To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts. MATERIALS AND METHODS: Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device. Perfusion imaging, pulmonary- artery pressure measurements, and pulmonary arteriography were performed before and after each procedure. RESULTS: A total of 22 procedures were performed (11 PSPMT and 11 mechanical thrombolysis). Declotting was successful in all procedures, with 100% 30-day patency. Segmental defects were seen on perfusion images after 10 (91%) of 11 PSPMT procedures and two (18%) of 11 mechanical thrombolysis procedures (P < .002). Transient increases in pulmonary-artery pressure occurred in the PSPMT group. Complete resolution of emboli and return to baseline pressures were seen in all cases, even after multiple (up to four) procedures in the same animal. There was no histologic evidence of pulmonary infarction in either group. CONCLUSION: The percutaneous thrombolytic device is effective for declotting dialysis grafts in dogs and results in statistically significantly fewer pulmonary emboli compared with PSPMT.

AB - PURPOSE: To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts. MATERIALS AND METHODS: Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device. Perfusion imaging, pulmonary- artery pressure measurements, and pulmonary arteriography were performed before and after each procedure. RESULTS: A total of 22 procedures were performed (11 PSPMT and 11 mechanical thrombolysis). Declotting was successful in all procedures, with 100% 30-day patency. Segmental defects were seen on perfusion images after 10 (91%) of 11 PSPMT procedures and two (18%) of 11 mechanical thrombolysis procedures (P < .002). Transient increases in pulmonary-artery pressure occurred in the PSPMT group. Complete resolution of emboli and return to baseline pressures were seen in all cases, even after multiple (up to four) procedures in the same animal. There was no histologic evidence of pulmonary infarction in either group. CONCLUSION: The percutaneous thrombolytic device is effective for declotting dialysis grafts in dogs and results in statistically significantly fewer pulmonary emboli compared with PSPMT.

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