Evaluation of Central Venous Catheter Thrombogenicity

Abstract

Four studies were performed to evaluate the thrombogenicity of different central venous catheter materials. Two of these studies consisted of evaluating the amount of platelet deposition on different catheter materials, firstly in uitro and then in uiuo using dogs. In these studies, 51-chromium was used to label the platelets. In the following study, the volume of clot and the degree of fibrin sheath were determined by placing catheters in both arteries and veins ofdogs for two to four weeks before removing the vessels and performing a quantitative analysis. For the fourth study, indium labelled platelet deposition with scintillation counting was performed on six dogs in whom catheters had been placed in the femoral and carotid arteries. The vessels in three of these animals were removed 48 hours after imaging was completed to correlate the scintigraphic findings with a quantitative analysis of the clot and fibrin sheath on each catheter. There was a high degree of correlation between all these studies. The most consistently thrombogenic catheter material was polyurethane, and the least thrombogenic catheter material was polyurethane coated with hydromer. Silicone was the next least thrombogenic material examined.

Adherence of staphylococci to intravascular catheters

“…Thrombogenicity is associated with the stiffness (Stenqvist et al, 1983) and the nature (Borow and Crowley, 1985) of the catheter material.…”

“…However, bacterial adherence is important in the initial stages of infections of prosthetic devices (Peters et al, 1982) and coagulase-negative staphylococci (CNS) and Staphylococcus aureus are the commonest organisms causing such infections (Press et al, 1984;Sattler et al, 1984;Harvey et al, 1986). The aim of this study was to investigate the initial adherence of CNS and S. aureus to two commonly used catheter materials, silicone and polyurethane, and to compare these with the adherence to polyurethane coated with Hydromer@, which makes surfaces more hydrophilic and reduces thrombogenicity (Borow and Crowley, 1985;Seifert and Greer, 1985).…”

Bedside Procedure: Retained Central Venous Catheter

“…Anticoagulation and thromboprophylaxis was studied in this subset of patients without evidence of prevention or benefit [5]. Efforts to reduce the thrombogenicity of the catheter materials have been ongoing for >30 years [48][49][50]. This led to the refinement of materials with recognition that polyethylene catheters have a higher incidence of thrombus while silicone and polyurethane exhibit improved biocompatibility [49,51].…”

Venous Catheterization Experimental Model in Rabbits: Histological Alterations in the Catheter Region

“…This tissual reaction is followed by platelet deposition and aggregation. In spite of being an expected event, this process may evolve into the formation of thrombi inside the catheter [14] [15].…”

“…Some materials such as Teflon ® or polyethylene are well known thrombogenic compounds, whereas catheters made of silicone are safer, biologically inert and more resistant to thrombosis [15]- [17]. Each catheter is designated by the vessel and the place in which its distal extremity is located, that is, peripheral or central; by the permanence time (temporary, short term, long term or permanent); by its insertion localization (subclavian vein, femoral vein, internal jugular vein, basilic and femoral peripheral veins); as well as peripheral insertion central catheters-PICC.…”