This study evaluates the frequency and significance of thrombus formation on the surface of intravascular ultrasound (US) imaging catheters. The investigation includes 63 consecutive patients who underwent 32 arterial and 38 venous intravascular procedures. At the end of the imaging procedure the US findings were observed during withdrawal of the catheter into the introducer sheath. Thrombus formation was demonstrated in 5 (7%). The largest thrombus fragments had a cross-sectional dimension of 2.2 x 1.0 mm. There was a significant correlation between the incidence of thrombus formation and the occurrence of malign neoplastic disease. No relation was found between the frequency of thrombus formation and the duration of the imaging procedure or the type of US catheter. It is concluded that the thrombogenicity of intravascular US imaging devices is not higher than that of conventional angiographic catheters. The observed "pull-out" thrombi were small and it is unlikely that they could have any clinical significance.
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