The effect of balloon catheter trauma on surface ultrastructure and fibrinolytic activity in the caval vein in rats.

Surgical procedures in veins such as thrombectomy are followed by a high complication rate. Re-occlusion is not uncommon in spite of primarily successful thrombectomy. The venous endothelium is damaged by the thrombotic process and the mechanical trauma from the balloon will be additive. The endothelial cells are the source of fibrinolytic activators. The present study compared changes in fibrinolytic activity in the vessel walls from the caval veins in rats to ultrastructural changes as seen in the scanning electron microscope. The balloon caused an almost complete denudation of the intima and the lesions were fully covered with platelets 1 hour after trauma. After 3 days reendothelialization had started. The fibrinolytic activity was significantly decreased at 1 and 24 hours following trauma. Reendothelialization was accompanied by return to normal fibrinolytic activity.