Document Detail


Selective venous thrombolysis with the nipple-balloon catheter: comparative evaluation in vivo.
MedLine Citation:
PMID:  10392954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare in an animal model of deep vein thrombosis, an intramural drug delivery catheter, the nipple-balloon catheter, with an occlusion balloon-infusion guide wire system. MATERIALS AND METHODS: Ten juvenile pigs were used for the study. Deep vein thrombosis was induced in both hind limbs by using a previously described technique. Heparin was administered 30 minutes later (2,500 IU intravenously) and bilateral thrombolysis was attempted with use of 8 mg of alteplase as a 0.25 mg/mL solution containing heparin 50 IU/mL (n = 10) and sodium/meglumine ioxaglate 40 mgI2/mL (n = 5). In one limb, the external iliac vein was endoluminally occluded, and 0.8 mL of alteplase was administered every 3 minutes through a multisideport infusion wire placed coaxially through the balloon catheter. On the other side, a nipple-balloon catheter was used: alteplase was injected as two 0.4-mL aliquots every 3 minutes in overlapping segments of the vessel. Blood samples were taken at predetermined intervals to determine the partial thromboplastin time and plasma fibrinogen concentration. At autopsy, the thrombus mass in the iliofemoral veins was measured, and the extent of residual thrombosis in the venous tributaries was graded at four sites. The heart and the lungs were also examined for thromboemboli (n = 5). Venous specimens were then subjected to X-ray fluorescence spectrometry to determine iodine content (n = 5). RESULTS: Bilateral thrombolysis could be successfully completed in all animals. No procedural problem associated with the use of the nipple-balloon catheter was encountered. The mass of residual thrombus in the axial veins was significantly lower in this group (P = .005). The drug delivery system used did not appreciably influence thrombolysis in the tributaries. Signs of macroscopic damage to the veins were not observed in any animal. None of the venous specimens had detectable levels of iodine. Small thromboemboli were found in the pulmonary circulation in three of five animals. Fibrinogen levels did not decrease during the procedure. CONCLUSIONS: The significantly lower residual thrombus burden associated with use of the nipple-balloon catheter suggests that the device may have the potential to be an effective delivery system for selective thrombolysis in veins.
Authors:
S Roy; F Laerum; F Brosstad; K Kvernebo; K S Sakariassen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  10     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-08-19     Completed Date:  1999-08-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  817-24     Citation Subset:  IM    
Affiliation:
Institute for Surgical Research, National Hospital, Oslo, Norway.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anticoagulants / administration & dosage,  therapeutic use
Balloon Dilatation / instrumentation*
Contrast Media / administration & dosage
Coronary Vessels / pathology
Disease Models, Animal
Drug Delivery Systems / instrumentation
Equipment Design
Femoral Vein / pathology
Fibrinogen / analysis
Fibrinolytic Agents / administration & dosage,  blood,  therapeutic use
Heparin / administration & dosage,  therapeutic use
Hindlimb / blood supply
Iliac Vein / pathology
Iodine / analysis
Ioxaglic Acid / administration & dosage,  diagnostic use
Partial Thromboplastin Time
Pulmonary Embolism / pathology
Spectrometry, X-Ray Emission
Swine
Thromboembolism / pathology
Thrombolytic Therapy / instrumentation*
Tissue Plasminogen Activator / administration & dosage,  blood,  therapeutic use
Venous Thrombosis / drug therapy*,  pathology
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Contrast Media; 0/Fibrinolytic Agents; 59017-64-0/Ioxaglic Acid; 7553-56-2/Iodine; 9001-32-5/Fibrinogen; 9005-49-6/Heparin; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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