Local intraarterial thrombolysis: In vitro comparison of various infusion catheters

Purpose: Catheters are compared in vitro to evaluate the efficacy of thrombolysis during urokinase infusion within the thrombus. Methods: Six catheters were introduced individually into human thrombus within a stenotic flow model. Urokinase was infused continuously into the thrombus. To quantify the efficacy of thrombolysis, pressure gradients were recorded proximal and distal to the thrombus and during the course of infusion. Uniformity of lysis was assessed radiographically. Results: The fastest and most homogeneous thrombolysis was achieved with the EDM and the straight-flush catheter, shown by decreasing transthrombotic pressure gradients. All other catheter designs showed less homogeneous and delayed thrombolysis (p ≤ 0.001, Friedmann- Test, Schaich-Hamerle). There was no significant difference in the efficacy of thrombus dissolution between the EDM and the straight-flush catheter (Wilcoxon, matched pairs, p > 0.7). Conclusion: The EDM catheter and the straight flush catheter achieved the most homogeneous and fastest thrombolysis, apparently due to the best urokinase distribution within the thrombus.