We have developed a mechanical thrombolytic
catheter which defibrinates a fresh intra-arterial
thrombus by wrapping
fibrin about its rotating shaft. Defibrination results in liquification of the
thrombus and reperfusion of the thrombotically occluded vessel. In this study, we employed this
catheter-based approach in dogs with
coronary thrombosis to simulate possible clinical use in acute
myocardial infarction. Total
coronary thrombosis was generated in 11 dogs. Spontaneous reperfusion did not occur over a 30-minute control period. All vessels studied were initially totally thrombosed. After
mechanical thrombolysis, there was a significant improvement in percent diameter
stenosis from 100% to 28 +/- 26% (P less than 0.001). After thrombolysis, angiographically graded blood flow was normal in 9 of 11 arteries and was mildly delayed in 2 of 11. Complications included perforation of 2 vessels. We conclude that
mechanical thrombolysis, with a rotating
catheter, results in prompt reperfusion of the
infarct vessel and significant improvement in distal blood flow. This approach, unlike angioplasty, removes the
thrombus and might serve as an alternative to or supplemental form of
mechanical thrombolysis.