Rotational approaches to atherectomy and thrombectomy
Ritchie, J.L.; Hansen, D.D.; Intlekofer, M.J.; Hall, M.; Auth, D.C.
Zeitschrift für Kardiologie 76(Suppl 6): 59-65
1987
ISSN/ISBN: 0300-5860 PMID: 3439260 Document Number: 295450
We have developed and tested a rotational, mechanical approach to arterial plaque removal (PTRA or Percutaneous Transluminal Rotational Atherectomy). An elliptical burr is rotated by a helical driveshaft at 150,000 rpm. The tip of the burr is embedded with small diamond chips, 30 micron in diameter. Plaque is thus abraded and particles of 2-5 micron in diameter are released downstream. Preliminary studies in a rabbit model of iliac atherosclerosis showed a reduction in percent diameter stenosis from more than 80% to less than 40%. Perforations are the current principal complication, occurring in 2 of the 13 rabbit arteries. A second rotational catheter system has been developed for removal of fresh thrombus (PRT-Percutaneous Rotational Thrombectomy). Low speed rotation (5000 rpm) of a non-cutting catheter promotes the selective winding of fibrin with subsequent lysis of thrombus. This was effective in 20 out of 21 total thrombotic occlusions in a canine model of fresh clot, with a single perforation early in the experiment.