Catheter systems

6 Hickman IV line fitted with coloured polycarbonate connectors. 

7 Section through connector to show internal structure. 

That broken products had indeed been sent for inspection was proved by photocopies of the letters of complaint, often with the broken device attached to the letter, and so photocopied as well. The many published reports on polycarbonate failures seemed to have been ignored, however. Because the users were blamed for the problem, no serious action was taken to either withdraw the faulty products from supply to hospitals, or to re-examine the design and manufacture of the connectors. Even when a new design using different polymer was introduced in early 1996, the older designs continued to be used by hospitals, including that where the premature baby was being treated. 

As the trial approached (set for May 2008), the experts engaged by each of the three parties to the action, organised a new examination of the connector 

many surfaces were contaminated by stains and particles, and 

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Simpson JB, Bairn DS, Robert EW, Harrison DC. A new catheter system for coronary angioplasty. Am J Cardiol 1982 49 1216. 

Transcoronary venous injection is performed with a catheter system threaded percutaneously into the coronary sinus. Initial studies in swine have confirmed the feasibility and safety of this approach [121]. This delivery method has also been used to deliver skeletal myoblasts to scarred myocardium in cardiomyopathy patients [120]. With intravascular ultrasound guidance, this approach allows the operator to extend a catheter and needle away from the pericardial space and coronary artery into the adjacent myocardium. To date, human feasibility studies have had a good safety profile. This technique is limited, however, by coronary venous tortuosity, lack of site specific targeting, and its own technically challenging nature. Unlike the transendocardial approach, in which cells are... 

Kornowski R, Fuchs S, Tio FO, Pierre A, Epstein SE, Leon MB. Evaluation of the acute and chronic safety of the biosense injection catheter system in porcine hearts. Catheter Cardiovasc / crvl999 48 447-453 discussion 454-A45. 

Gonschior, P., Pahl, C., Huehns, T.Y., Gerheuser, F., Erdemci, A., Larisch, K. et al. (1995) Comparison of local intravascular drug-delivery catheter systems. Am. Heart J., 130, 1174-1181. 

Kittrell, C. 8c Feld, M.S. Catheter System for Imaging World Intellectual Property Organization Patent Cooperation Treaty International Application WO 89/02718 Assigned to Massachusetts Institute of Technology Filed in 1988. Priority Number US 100714 (1987). 

Hence, intrathecal baclofen offers a means of treating certain patients with severe spasticity who have not responded to more conventional means of treatment including oral baclofen. Additional research will help determine optimal ways that this intervention can be used to decrease spasticity. Further improvements in the technologic and mechanical aspects of intrathecal delivery, including better pumps and catheter systems, will also make this a safer and more practical method of treating these patients. 

Mathias K. [A new catheter system for percutaneous transluminal angioplasty (PTA) of carotid artery stenoses]. Fortschr Med 1977 95 1007-101 I. 

Theron J, Courtheoux P Alachkar F Bouvard G, Maiza D. New triple coaxial catheter system for carotid angioplasty with cerebral protection. AJNR Am J Neuroradiol 1990 ... 

Figure 15. Subcooled liquid nitrogen catheter system. One nitrogen dewar is pumped on with a vacuum pump to cool it below 77 K.

Figure 16. High pressure Joule-Thomson catheter system.

Figure 17. Vapor-compression catheter system. Heat exchanger in handle is optional, but will yield lower temperatures.

Figure IS. Two-stage vapor-compression catheter system.

Wilcox, CM., Woods, B.L., Mixon, H.T. Prospective evaluation of a peritoneal dialysis catheter system for large volume paracentesis. Amer. J. Gastroenterol. 1992 87 1443-1446... 

Plasmid-mediated resistance to silver salts is of particular importance in the hospital environment, because silver nitrate and silver sulphadiazine may be used topically for preventing infections in severe burns. It may have increased relevance in the future arising from the use of silver-coated connectors in catheter systems. Silver reduction is not a primary resistance mechanism as sensitive and resistant cells can equally convert Ag+ to metallic silver. Plasmid-mediated resistance to silver salts is, in fact, difficult to demonstrate, but where it has been shown to occur, decreased accumulation rather than silver reduction is believed to be the mechanism involved. 

The use of an indwelling catheter frequently is associated with infection of the urinary tract and represents the most common cause of hospital-acquired infection. The incidence of catheter-associated infection is related to a variety of factors, including method and duration of catheterization, the catheter system (open or closed), the care of the system, the susceptibility of the patient, and the technique of the health care personnel inserting the catheter. The incidence of infection from a single catheterization in a healthy ambulatory patient is 1%. Bacteria may enter the bladder in a number of ways. During the catheterization, bacteria may be introduced directly into the bladder from the urethra. Once the catheter is in place, bacteria may pass up the lumen of the catheter via the movement of air bubbles, by motility of the bacteria, or by capillary action. In addition, bacteria may reach the bladder from around the exudative sheath that surrounds... 

Brandner P, Neis KJ. Use of an implantable catheter system for intraperitoneal chemotherapy in ovarian cancer. Artif Organs 1994 18 328-330. 

Neomycin sulfate is available for topical and oral administration. Neomycin and polymyxin B have been used for irrigation of the bladder. For this purpose, 1 mL of a preparation (neosporin G. u. irrigant) containing 40 mg neomycin and 200,000 units polymyxin B per milliliter is diluted in 1 L of 0.9% NaCl solution and is used for continuous irrigation of the urinary bladder through appropriate catheter systems. The goal is to prevent bacteriuria and bacteremia associated with the use of indwelling catheters. 

Active implants, such as pacemakers, cardioverters (ICDs), and neurostimulators, are increasingly using impedance measurements (Yu et al. 2005 Vollmann et al. 2007). The implants are already equipped with advanced electronic circuitry and advanced multielectrode catheter systems together with data storage and communication facilities. Parameters of interest are, for instance, CO, myocardial contractility, ischemia, and thoracic fluid accumulation. 

Fig. 3.8. Male patient suffering from a multifocal hepatocellular carcinoma (HCC), treated with repeated sessions of transarterial chemoembolization (TACE). Dyna-CT (Siemens Medical Solutions, Erlangen, Germany) image started together with injection of 10 ml iodinated contrast agent via a super-selective catheter system placed in the right hepatic artery compared with a corresponding MDCT section in the arterial phase after i.v. injection of 120 ml iodinated contrast agent. Note the excellent, direct depiction of arterial blood supply of the HCC nodule in liver segment 5/8 (arrow). The artifacts in the left and right liver lobe are caused by spots of Lipiodol in already treated HCC nodules after earlier transarterial chemoembolization...

Integral to using pushable fibered coils to produce cross sectional occlusion is the use of coaxial or tri-axial guide catheter systems. For venous occlusions (varicocele and/or pelvic congestion) or occlusions of PAVMs, we use standard 7/5 combinations (Pulmonary, Cook) or gonadal (Cordis Inc., Miami FL) with inner 5-F endhole catheters (Fig. 3.9). 

Zuckerman DA, Gaz RD (1991) Catheter-guided intraoperative localization of a jejunal angiodysplasia using the Tracker-18 coaxial catheter system case report. Cardiovasc Intervent Radiol 14 358-359... 

Sensei robotic catheter system [updated 28 March 2011 cited 12 May 2011]. http //en.wikipedia.org/wiki/Sensei robotic catheter system... 

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