Comparison of Symmetric Hemodialysis Catheters Using Computational Fluid Dynamics

Abstract

The VectorFlow catheter produced less shear-induced platelet activation than the Palindrome catheter and less flow separation than the Palindrome and GlidePath catheters irrespective of line configuration. These findings have potential implications for differences in thrombogenic risk during clinical performance of these catheters.

Survival and Clinical Outcomes of Tunneled Central Jugular and Femoral Catheters in Prevalent Hemodialysis Patients

“…We selected the Tal Palindrome catheter based on its design and literature reports of better survival time and lower complication rates [19][20][21].…”

Initial Clinical Experience: Symmetric-Tip Dialysis Catheter with Helical Flow Characteristics Improves Patient Outcomes

“…This catheter was developed with the goal of improving catheter performance by optimizing fluid dynamics through helical flow-deflecting interfaces at the catheter tip. This tip design is intended to reduce platelet activation while minimizing recirculation (7,8). Initial clinical experience with this catheter was compared with a conventional split-tip device, the Ash Split Cath catheter (Medcomp, Harleysville, Pennsylvania), in the present retrospective analysis.…”

Numerical/Experimental Synergy: More Than Just a Reality Check

“…As stated earlier, simplifying assumptions are often necessary to make a numeric model tractable. However, numerical models of hemodialysis catheters have been performed without making some of the simplifying assumptions used in the study of Clark et al (1). One recent article (4) included a realistic internal jugular vein geometry, nonNewtonian blood rheology, turbulence, and unsteady flow.…”

“…Unfortunately, similar definitions are not always available. For example, in the analysis of Clark et al (1), the Palindrome catheter demonstrated as much as 345% greater shear-induced platelet activation than the VectorFlow catheter. However, it is not known whether this is a clinically significant difference.…”

“…Experimental studies in pig models have measured recirculation for various catheters in forward and reverse operation (6); however, the catheters considered in Clark et al (1) have not yet been compared experimentally. One of the great strengths of numerical models is that they can help to explain the results of previous, or future, experimental studies (7-10).…”