Q:

Which of the following is/are not true of the embolectomy catheter technique?

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Which of the following is/are not true of the embolectomy catheter technique?


  1. The balloon should be inflated by the same person who withdraws the catheter.
  2. Distal exploration should be carried out in all major branches of the affected extremity
  3. The balloon is designed to dilate as it traverses areas of luminal narrowing.
  4. Removal of adherent thrombus requires alternate catheter-based therapy in addition to balloon exploration.

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C. The balloon is designed to dilate as it traverses areas of luminal narrowing.

DISCUSSION: The embolectomy balloon should be adjusted in diameter as the catheter is withdrawn to accommodate changes in luminal diameter and to effect appropriate traction. To do so, the operator must simultaneously control the withdrawal and the balloon inflation. The propensity of clot to propagate distally and proximally requires nearby branches to be explored. When it is technically feasible, major branches should be explored. The embolectomy balloon is made of a distensible elastomer that conforms to the intra-arterial surface to maintain wall contact. Dilatation balloons, in contrast, are made of a nondistensible material that can effect dilating force on the arterial narrowing. An increase in the incidence of adherent thrombus from chronic atherosclerotic disease and failed synthetic grafts has promoted the development of more aggressive catheter-based systems. Graft thrombectomy and adherent clot catheters are specifically designed to remove adherent thrombus left behind after balloon exploration.

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