Balloon embolectomy catheter-induced arterial injury: a comparison of four catheters.
This study compared four brands of balloon embolectomy catheters with respect to their mechanical characteristics and the histologic responses they elicit. Seventy-two 4F Becton-Dickinson, Edwards, Electro-Catheter, and Shiley catheters were studied. In vitro studies of penetration forces demonstrated that the forces required for arterial puncture were greatest for Shiley (295 +/- 22 gm) and least for Edwards catheter tips (217 +/- 11 gm) (p less than 0.05). This indicates that the Shiley catheter is least likely to puncture vessels in patients. Studies of balloon eccentricity showed that none of the balloons distended with excessive eccentricity. Studies of balloon emptying time demonstrated that the silicon Becton-Dickinson balloon required more than two times as long (5.7 +/- 1.2 seconds) as all other balloons to empty. Balloon emptying time reflects the ability of the surgeon to rapidly adapt the balloon to changing vessel diameter in patients. Shear forces were studied in cylindrical segments of arteries in vitro. Initial shear forces were significantly different among all catheters, Becton-Dickinson greater than Edwards greater than Shiley greater than Electro-Catheter (p less than 0.05). In contrast, during catheter withdrawal dynamic shear forces were similar among the four brands of catheters. Balloon embolectomies were performed in vivo in the common carotid and common femoral arteries in 18 anesthetized dogs. Histologic examinations of the vessels exposed to 50, 100, and 200 gm shear forces showed that myointimal hyperplasia increased with rising shear forces for all catheters (p less than 0.05), but that there were no differences in the degree of myointimal hyperplasia elicited by the different brands of catheters.(ABSTRACT TRUNCATED AT 250 WORDS)
Schwarcz
T H
TH
Department of Surgery, Loyola University Medical Center, Maywood, Ill.
Dobrin
P B
PB
Mrkvicka
R
R
Skowron
L
L
Cole
M B
MB
D000818:Animals; D001158:Arteries / Q000293:injuries*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D004285:Dogs; D004617:Embolism / Q000628:therapy*; D004867:Equipment Design; D011817:Rabbits; D012421:Rupture; D013314:Stress, Mechanical; D013997:Time Factors