Atheroablation with the Kensey catheter: a pathologic study.

Abstract

The mode of action of the Kensey catheter, a new atheroablation device, was ivestigated. Fresh above-the-knee amputated legs were used for recanalization of the superficial femoral artery. The variables used were identical to those of clinical trials, including a rotational speed of 50,000 rpm and an injection rate of 40 mL/min. The debris produced by the catheter was studied cytologically and the arterial segments were examined histologically. The particle size in the debris ranged from 1 to 2,000 .mu.m. The softer plaques produced a fine fibrin dust background with long strips of intima ranging from 10 to 2,000 .mu.m. Complicated calcified plaques produced larger background material (10-120 .mu.m) but smaller strips of intima (50-800 .mu.m). Dissections and perforations occurred. Some of the debris produced by the atheroblation process was used to embolize a canine heart and kidney. Small focal infarctions were found in the heart, and larger and multiple infarcts were seen in the kidney. In clinical studies the debris appears to be tolerated in the lower extremities. Its safety in the kidney and heart are questioned.