Percutaneous mechanical thrombolysis and thrombectomy

Abstract

Devices and methods for mechanically dissolving (thrombolysis) and removing (thrombectomy) thrombus using a percutaneous approach have been developed to address the deficiencies of the previously available methods of treating thrombus, namely Fogarty balloon thromboembolectomy and pharmacologic thrombolysis. Goals of percutaneous mechanical thrombectomy (PMT) include faster, safer, and less expensive treatment of vascular thrombosis, either alone or in conjunction with prior methods. PMT devices have rapidly assumed a role in declotting thrombosed hemodialysis access synthetic grafts, and may eventually play an integral part in many other thrombotic conditions. However, significant device refinement and modification, as well as properly conducted clinical trials, will be necessary before routine use in many applications can be advocated. In this article, each of the PMT devices currently (or soon to be) available in the United States are presented and compared. Each is approved by the Food and Drug Administration for use only in hemodialysis access at the present time.