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Development of a new catheter prototype for laser thrombolysis under guidance of optical coherence tomography (OCT): validation of feasibility and efficacy in a preclinical model

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Abstract

In this feasibility study, a novel catheter prototype for laser thrombolysis under the guidance of optical coherence tomography (OCT) was designed and evaluated in a preclinical model. Human arteries and veins were integrated into a physiological flow model and occluded with thrombi made from the Chandler Loop. There were four experimental groups: placebo, 20 mg alteplase, laser, 20 mg alteplase + laser. The extent of thrombolysis was analyzed by weighing, OCT imaging and relative thrombus size. In the alteplase group, thrombus size decreased to 0.250 ± 0.036 g (p < 0.0001) and 14.495 ± 0.526 mm2 (p < 0.0001) at 60 min. The relative thrombus size decreased to 73.6 ± 4.1% at 60 min (p < 0.0001). In the laser group, thrombus size decreased significantly to 0.145 ± 0.028 g (p < 0.0001) and 11.559 ± 1.034 mm2 (p < 0.0001). In the alteplase + laser group, thrombus size decreased significantly (0.051 ± 0.026 g; p < 0.0001; 9.622 ± 0.582 mm2; p < 0.0001; 47.4 ± 6.1%; p < 0.0001) in contrast to sole alteplase and laser application. The reproducibility and accuracy of the OCT imaging was high (SD <10%). Histological examination showed no relevant destruction of the vascular layers after laser ablation (arteries: 745.8 ± 5.5 μm; p = 0.69; veins: 448.3 ± 4.5 μm; p = 0.27). Thus, laser ablation and OCT imaging are feasible with the novel catheter and thrombolysis combining alteplase with laser irradiation appears highly efficient.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, University of Schleswig-Holstein, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany

    Rouven Berndt, Rene Rusch, Katharina Huenges, Bernd Panholzer, Assad Haneya, Georg Lutter, Jochen Cremer & Justus Groß

  2. Department of Anesthesiology and Surgical Intensive Care, University of Schleswig-Holstein, Kiel, Germany

    Lars Hummitzsch

  3. Department of Cardiology, University of Schleswig-Holstein, Kiel, Germany

    Matthias Lutz

  4. Institute of Neuropathology, University Hospital Münster, Münster, Germany

    Katharina Heß

  5. Institute of Medical Technology, Hamburg University of Technology, Hamburg, Germany

    Christoph Otte & Alexander Schlaefer

Authors
  1. Rouven Berndt
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  2. Rene Rusch
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  3. Lars Hummitzsch
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  9. Assad Haneya
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  10. Georg Lutter
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Corresponding author

Correspondence to Rouven Berndt.

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The authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Rouven Berndt and Rene Rusch have contributed equally to this work.

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Berndt, R., Rusch, R., Hummitzsch, L. et al. Development of a new catheter prototype for laser thrombolysis under guidance of optical coherence tomography (OCT): validation of feasibility and efficacy in a preclinical model. J Thromb Thrombolysis 43, 352–360 (2017). https://doi.org/10.1007/s11239-016-1470-0

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  • DOI: https://doi.org/10.1007/s11239-016-1470-0

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