Catheter guided mechanical thrombectomy is particularly important when contraindications to thrombolysis are present or when surgical embolectomy is not feasible or not available.
An ideal percutaneous PE mechanical thrombectomy catheter should be:
1) Highly maneuverable to allow rapid right heart passage and advancement into major pulmonary arteries,
2) Effective in removing obstructing thrombi from major pulmonary arteries to facilitate rapid improvement in hemodynamics, reversing right heart failure and cardiogenic shock, and
3) Safe without causing damage to cardiac structures and pulmonary arteries, and without causing significant blood loss, distal thrombus embolization, and mechanical hemolysis.
The Aspirex S Mechanical Thrombectomy Catheter
The Aspirex S Catheter is designed for mechanical thrombectomy in acute occlusions in veins and arteries and for dialysis access.
According to the manufacturer, the device offers three functions: aspiration of fresh thrombus and emboli, fragmentation of aspirated material and transportation out of the patient`s body.
The Aspirex mechanical thrombectomy device (Straub Medical) was specifically designed and developed for percutaneous interventional treatment of PE in pulmonary arteries, ranging from 6-14 mm in caliber. The central part of the mechanical thrombectomy catheter system is a high-speed rotational coil within the catheter body that:
- Creates negative pressure through an L-shaped aspiration port at the catheter tip,
- Macerates aspirated thrombus, and
- Removes macerated thrombus.
The aspiration capacity of the Aspirex mechanical thrombectomy device was adjusted to remove thrombus from obstructed major pulmonary arteries and to minimize the risk of vascular collapse and vessel wall engagement. This was achieved by adjusting the caliber of the device, the pitch of the rotational coil, motor speed, and size or configuration of the aspiration port at the catheter tip.
Aspirated blood cools off and lubricates the catheter system. The design of the Aspirex mechanical thrombectomy catheter does not allow recirculation of aspirated blood. In static in-vitro tests using human blood samples, aspiration with the Aspirex device was not associated with an increase in plasma free hemoglobin.