Material Thrombogenicity in Central Venous Catheterization II. A Comparison between Plain Silicone Elastomer, and Plain Polyethylene, Long, Antebrachial Catheters

Abstract

Central venous catheters of two types were inserted through basilic or cephalic veins punctured at the fossa cubiti in 61 patients: 39 soft silicone elastomer (S.E.) and 22 stiffer polyethylene (P.E.) catheters were compared regarding their thrombogenicity. Mean duration of catheterization was 6.5 days. Radiological thrombi in the peripheral and central veins visualized by phlebography were significantly smaller, and the incidence of the mural thrombi in the central veins significantly lower with the S.E. than with the P.E.-catheters, but the use of S.E.-catheters did not reduce the incidence of clinical thrombophlebitis in arm veins: 14 cases in the group with S.E. and four in that with P.E.-catheters. In both groups, the maximum incidence of clinical thrombophlebitis occurred 4-8 days after catheterization. Later, there seems to be a low risk for the appearance of clinical thrombophlebitis with both catheters. Neither the surface topography of the catheter materials, nor the platelet adhesion on their surfaces in contact with human blood in vitro offered conclusive arguments for interpretation of their thrombogenicity in vivo. Catheter stiffness seems to play an important role in inducing mural thrombus formation in central venous cannulation in man.

Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC)

“…With regard to CRTCs, in the past years, different reviews have reported a variable but relatively high incidence of such complications (4-36 %) in patients with a PICCs indwelling [11,[13][14][15][16]. In the last 10 years, after the introduction of ultrasonographic techniques to monitor PICCs' insertion, the rate of thrombosis has decreased significantly and has been reported to occur in about 2-5 % of patients [6,17,18].…”

Relationship of anticoagulation and radiographic contrast agents to thrombosis during coronary angiography and angioplasty: Are there real concerns?

“…However, in general, materials having hydrophobic surface groups such as polyethylene are believed to minimize the platelet thrombosis of arterial, high shear rate flow conditions [12]. On the other hand, hydrophilic surface groups such as are present in polyurethane, may be best to reduce the fibrin-red cell clot characteristic of venous, low shear rate flows [13]. Using a radiolabeled platelet technique and scanning electron microscopy in dogs, for example, Solomon and colleagues [ 141 have shown that platelet deposition can vary twelve-fold depending on catheter material and on whether heparin bonding has been used.…”

Vascular Access in Oncology Patients

“…Catheters with a rough surface are more thrombogenic than those with a smooth surface (radiopaque barium sulfate filler can have an influence). Some studies 29,30 suggest that silicone may be less thrombogenic than some specific types of polyurethane. Polycarbonate-based polyurethane is more stable and less thrombogenic than polyether-based polyurethane.…”