Document Detail

Quantitative evaluation of selective thrombolysis techniques: influence of catheter characteristics and delivery parameters.
MedLine Citation:
PMID:  9473207     Owner:  NLM     Status:  MEDLINE    
Here, we evaluate in vitro the site-specific delivery ability of thrombolysis catheters and compare continuous infusion (CI) and periodic injection (PI) protocols with reference to this parameter. Thrombotic occlusion was simulated by placing a porcine blood clot proximal to an eccentric stenosis in a flow phantom. Iodinated contrast agent was used as the marker. Part I-Evaluation of thrombolysis catheters: four CI and three PI catheters were tested. The marker was delivered as an infusion at 1 ml/min for 1 min (CI), or as two 0.25 ml boluses 30 sec apart (PI). Iodine content of the clot was then estimated with x-ray fluorescence spectrometry. This value as a ratio of the delivered dose was defined as the targeting efficiency. Part II-Evaluation of thrombolysis protocols: CI and PI were compared. The marker was delivered for 3 or 5 min using one of seven protocols. The iodine content of both clot and effluent were estimated. Among PI catheters, the Jet-Lysis catheter proved to be the best (P = 0.02). The EDM catheter had the lowest targeting efficiency in the CI group (P = 0.01). With CI, median iodine recovery dropped from 0.21 (95% confidence interval: 0.08, 0.25) for 1 min to 0.13 (0.05, 0.16) for 3 min and 0.07 (0.03, 0.10) for 5 min; for PI the values remained unchanged. The fraction lost in the effluent increased with the duration of regimen with both CI (P = 0.014) and PI (P = 0.004). Reducing the rate of infusion or the bolus frequency resulted in major improvements with respect to this parameter (P = 0.005). For CI, the targeting efficiency increased as well (P = 0.03). We conclude that currently used thrombolysis protocols do not fully exploit the delivery advantage offered by CI or PI. Fortunately, simple modifications offer the possibility of overcoming these drawbacks.
S Roy; F Laerum; F Brosstad
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  43     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-05     Completed Date:  1998-03-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  111-9     Citation Subset:  IM    
Institute for Surgical Research, National Hospital, Oslo, Norway.
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MeSH Terms
Equipment Design
Fibrinolytic Agents / administration & dosage
Phantoms, Imaging
Thrombolytic Therapy / instrumentation*,  methods
Reg. No./Substance:
0/Fibrinolytic Agents

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