Material thrombogenicity in central venous catheterization: a comparison between soft, antebrachial catheters of silicone elastomer and polyurethane

Abstract

In order to compare two types of long, soft central venous catheters with the same stiffness, 39 silicone elastomer (SE) and 36 polyurethane (PU) catheters were inserted in 75 patients via basilic or cephalic veins punctured at the cubital fossa. Mean duration of catheterization was 10.5 days. Scanning electron microscopy revealed that the SE catheters to have a more uniform, but somewhat rougher surface topography than the PU catheters. The platelet adhesion in vitro to the SE catheters was four times higher than to the PU catheters. The incidence of clinical thrombophlebitis in the arm veins was 36% with the SE catheters, and 5.5% with the PU catheters (p less than 0.01). No significant differences were found between the SE and PU catheters regarding the number and size of radiologic thrombi in the peripheral and central veins, catheter occlusion rate, and platelet adhesion to the inner side of the catheter tip at withdrawal. Platelet adhesion in vivo correlated with the duration of catheterization in both groups of catheters. Mechanical trauma to the vein endothelium seems to be of vital importance in thrombus formation, but not in the induction of clinical thrombophlebitis.

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].…”

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.…”

Infusion Phlebitis in Post-Operative Patients: When and Why

“…Consequently, prophylaxis was directed by using short cannulation times, adding buffers, and using in-line membrane filters to remove microparticulate components present in the infusion fluids. Some years later, a role of the catheter material in the pathogenesis of phlebitis was demonstrated [1,[6][7][8][9][10], and efforts were directed to achieve more flexible and less adherent catheters. Now we demonstrate that blood cells play also a role in the genesis of such complications.…”