Which Medical Device - Expert Independent Opinion
The Pronto V4 extraction catheter is designed for the removal of fresh, soft emboli and thrombi from coronary and peripheral arteries as small as 1.75mm in diameter. The uniformly large extraction lumen and embedded longitudinal wire offer maximum extraction with enhanced deliverability and kink...
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(From Vascular Solutions)
The Pronto V4 extraction catheter is designed for the removal of fresh, soft emboli and thrombi from coronary and peripheral arteries as small as 1.75mm in diameter. The uniformly large extraction lumen and embedded longitudinal wire offer maximum extraction with enhanced deliverability and kink resistance. The Pronto V4 features the patented Silva distal tip, designed to protect the vessel wall during insertion and extraction, and is currently available in 7F and 8F sizes.
The Pronto V3 extraction catheter is designed for the removal of fresh, soft emboli and thrombi from vessels in the coronary and peripheral vasculature during percutaneous interventions. Its large extraction lumen and proprietary Silva tip offer maximum extraction combined with vessel wall protection.
The Pronto LP is a low-profile extraction catheter designed for the removal of soft thrombus from coronary and peripheral arteries as small as 1.5mm in diameter. Compatible with any 0.014" guidewire and all 6F guide catheters (min I.D. 0.066"), it combines a very low crossing profile with a hydrophilic coating and an innovative braid- and stylet-reinforced proximal shaft.
The Pronto .035" extraction catheter offers a complete system for the removal of thrombus from arteries and veins greater than 4mm in diameter. Compatible with standard 0.035" guidewires and 10F sheaths, it offers easy over-the-wire delivery. The 120-degree angled distal 4cm of the Pronto .035" provides enhanced steerability and vessel selection, and its braid-reinforced shaft increases tip control and resists kinking.
The Pronto V4 extraction catheter (Vascular Solutions) was put to use following extensive distal embolisation into the popliteal artery when treating an SFA occlusion. The thrombus extended well into the AT and TPT making it very difficult to access in its entirety but this catheter proved its worth.
Using an 0.014 wire initially parked in proximal PT (then later the AT) the catheter advanced easily and rapidly into the clot burden. The procedure was being performed from a contra-lateral approach due to uncertainty of the need to treat a possible inflow EIA stenosis, but the 138cm working length rapid exchange catheter facilitated access of the distant problem area.
The supplied 30ml lockable syringe allowed thrombectomy without needing to apply continuous suction, aspirating copious amount of cholesterol thrombus. The vast majority of the thrombus being cleared over a relatively short period of time.
Other advantages would be the short time taken to start aspirating, when compared to setting up the AngioJet system.
Disadvantages would be the rather fragile nature of the catheter. It's quite easy to kink it at the entry point to the vascular sheath, probably in part due to the fact an 0.014 wire is being used but its durability would be questionable if using for a prolonged period of time.
Overall impressive and useful device being very easy and quick to use.
