Venous valvular assessment after retrograde catheterization

Abstract

Purpose: To determine whether retrograde passage of a coaxial infusion system (Mewissen-Katzen catheter and guide wire) into extremity veins with valves causes damage.

Materials and methods: Retrograde common femoral vein puncture and passage of an infusion wire-catheter system through the superficial femoral and popliteal veins of one leg were performed in five anesthetized pigs. Heparinized saline was then infused via the catheter and wire for approximately 8 hours. The pigs were then killed, and the femoropopliteal veins were removed from both legs of each pig and examined by a pathologist. The noncatheterized leg veins served as a control in each animal.

Results: Valvular damage occurred in one of five pigs. This may have resulted from leg movement during catheter passage in this animal.

Conclusion: Retrograde passage of a catheter-guide-wire infusion system caused minimal to no damage to the venous valves of pigs. This suggests that human venous valves may be spared injury during catheter-directed venous thrombolysis. Further study of catheter manipulation in a model of deep venous thrombosis is needed.