Nonhealing wound resulting from a foreign‐body reaction to a radial arterial sheath

Subramanian, Rajesh; White, Christopher J.; Sternbergh, W. Charles; Ferguson, Daniel L.; Gilchrist, Ian C.

doi:10.1002/ccd.10468

Cited by 57 publications

(42 citation statements)

References 48 publications

(62 reference statements)

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“…There have been a few previous reports in the literature regarding this complication following radial artery facilitated cardiac catheterization with hydrophilic coated sheaths, suggesting an incidence of 2.8% in one center [2].…”

Section: To the Editormentioning

confidence: 97%

Sterile granuloma formation following radial artery facilitated coronary catheterization

Sado¹,

Witherow²

2009

Cathet Cardio Intervent

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Section: To the Editormentioning

confidence: 97%

Sterile granuloma formation following radial artery facilitated coronary catheterization

Sado¹,

Witherow²

2009

Cathet Cardio Intervent

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“…Further, the use of certain hydrophilic coatings (for example, those manufactured by Cook [12,13]) has been associated with the formation of sterile granulomas and abscesses [14][15][16][17][18]. Clearly, there is substantial room for improvement in the field of lubricious coatings for endovascular catheter use and, in particular, biodegradability would be a marked advantage.…”

Section: Introductionmentioning

confidence: 99%

Friction behaviour of hydrophilic lubricious coatings for medical device applications

Niemczyk

Fray

Franklin

2015

Tribology International

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The friction behaviour of new chitosan derivative coatings obtained by chemical modification of chitosan with fatty acids (linoleic and dilinoleic acid) has been investigated in order to explore their potential as endovascular catheter coatings and to benchmark them against commercially available coatings used in endovascular catheter applications. An in vitro tribological system was developed that was intended to represent to a limited extent the in vivo tribological conditions of a typical endovascular catheterization procedure. Continuous reciprocating sliding tests were carried out with uncoated and coated polymer specimens. The results showed that all of the coatings tested decreased the coefficient of friction compared to the uncoated polymer. Compared to a neat chitosan coating, the chitosan derivative coatings showed a clear reduction in the coefficient of friction to levels similar to those of the commercially-available coatings. A comparison between the friction results and contact angle measurements carried out on the coatings indicated that a range of contact angle values exists for which the friction coefficient is at a minimum. The reason for this is unclear and further studies are required in order to confirm and investigate the trend, especially within the context of hydrophilic lubricious coating development.

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“…Since then, 'sterile inflammation' has been described as a rare complication of hydrophilic coating originating from medical devices. After cardiac catheterization and coronary angiography procedures, this has manifested clinically as painful, non-healing dermal wounds at the access site, [5][6][7][8][9][10] shown on biopsy to be extravascular or perivascular granulomata harboring extracellular deposits of polymer material (likely originating from coated Cook arterial introducer sheaths). 'Aseptic' and 'chemical' meningitis, documented in five patients, 11,12 likely resulted from disseminated polymer materials (although clinical findings in these cases were not confirmed by histopathologic evaluation).…”

mentioning

confidence: 99%

Hydrophilic polymer emboli: an under-recognized iatrogenic cause of ischemia and infarct

et al. 2010

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With the increased use of percutaneous intravascular diagnostic and therapeutic devices, there is potential for embolization of materials introduced into the vasculature. We report nine cases of foreign body emboli in patients who underwent vascular procedures using hydrophilic-coated medical devices. The procedures performed included cardiac catheterization (four cases), diagnostic cerebral angiography (two cases), therapeutic cerebral angiography with coil embolization of intracerebral aneurysm (one case), lower extremity angiography (one case), and/or orthotopic cadaveric organ transplantation (three cases). Other procedures in these patients included hemodialysis and peripheral arterial or central venous catheterization. Clinical sequelae ranged from undetectable (no symptoms) to pulmonary infarction, stroke, ongoing gangrene, and/or death occurring within days to weeks of suspected embolization of foreign material. Microscopic findings in biopsy or autopsy tissue revealed aggregates of amorphous or lamellated, non-refractile, non-polarizable, predominantly basophilic foreign substances occluding intrapulmonary, intracerebral, or peripheral arteries. This is the largest series documenting embolization of polymer gel materials. Polymer gel is now widely used on several devices for interventional procedures worldwide, and we suspect that complications associated with iatrogenic embolization of this substance are under-recognized.

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Nonhealing wound resulting from a foreign‐body reaction to a radial arterial sheath

Cited by 57 publications

References 48 publications

Sterile granuloma formation following radial artery facilitated coronary catheterization

Sterile granuloma formation following radial artery facilitated coronary catheterization

Friction behaviour of hydrophilic lubricious coatings for medical device applications

Hydrophilic polymer emboli: an under-recognized iatrogenic cause of ischemia and infarct

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