However, the standard catheters used in the above-mentioned studies were not tailored for pulmonary arterial recanalization. A dedicated system may deliver better results.
Following these considerations, we and others have spent a great deal of effort in the development of a pulmonary fragmentation catheter, favoring technically sophisticated solutions with high-speed rotating catheter tips, especially encaged or encapsulated impellers there canadian drug mall. Animal experimental testing of these devices revealed complex handling, difficulties in pulmonary placement and steerability, technical failures, eg, breakage of the rotation axis, and histologic evidence of pulmonary arterial wall damage.’ Nevertheless, there is one report of a partially successful clinical employment of such a high-speed rotating catheter.
The ideal catheter system for treatment of acute massive pulmonary embolism should be rapidly placed and well steerable in all parts of the pulmonary artery system. Ease of handling is an important feature, saving time and avoiding complications in an emergency procedure.
The pigtail rotation catheter concept was chosen under the consideration that the pigtail tip is the safest configuration for probing of the pulmonary arteries. The pigtail tip avoids perforation and allows easy manipulation into and within the pulmonary arteries. Starting out from the standard pigtail catheter design, only slight modifications were made to enable a continuous fragmentation function.
Experimental testing of the pigtail rotation catheter in dogs confirmed ease of handling and pulmonary steerability. Clot fragmentation was coarse compared with the pulverization achievable by impeller catheter treatment, but this seemed acceptable in consideration of the clinical goal to accomplish a partial but rapid recanalization for reduction of the right ventricular load.