Mechanic and surface properties of central-venous port catheters after removal: A comparison of polyurethane and silicon rubber materials

Braun, Ulrike; Lorenz, E. S.; Weimann, Christiane; Sturm, Heinz; Каримов, И. А.; Ettl, Johannes; Meier, Reinhard; Wohlgemuth, Walter A.; Berger, Hermann; Wildgruber, Moritz

doi:10.1016/j.jmbbm.2016.08.002

Cited by 42 publications

(25 citation statements)

References 24 publications

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“…A major concern with the materials used for catheters is whether they have degradation of their surface that could result in increased thrombogenicity or infection risk due to biofilm formation. A study looking at the mechanical and surface properties of silicone and polyurethane demonstrated that, even when exposed to short‐term and long‐term submersion in chemotherapeutic solutions, these two materials showed no significant surface degradation . However, with time, both materials developed surface irregularities as a result of lost barium sulfate molecules, which are embedded in the polymer for the purpose of making the catheters radiopaque.…”

Section: Catheter Materialsmentioning

confidence: 99%

Implanted vascular access device options: a focused review on safety and outcomes

Blanco-Guzman

2018

Transfusion

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Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications. We review the evidence related to these advances and their effect on the safety profile and complications of implantable vascular access device ports. Since the first report of a fully implantable vascular access device (IVAD) in 1982, 1 the use of these devices has grown exponentially. They consist of a reservoir cradled in the subcutaneous tissue that is connected to a catheter, with its tip terminating into a major vein. IVADs are frequently used in patients who have poor peripheral venous access and are in need of long-term administration of vesicant drugs, antimicrobials, blood products, or parenteral nutrition.2,3 They also are used as access for long-term therapeutic apheresis procedures. 4 Although nonimplanted, long-term catheters can be used for all of these purposes as well, the lack of an external component in IVAD ports provides multiple advantages; patients have improved perceptions of quality of life and body image and less limitation in their mobility. 5 These ports also minimize the need for maintenance care and risk of infectious complications when the IVAD is not in use. 6 These benefits of IVAD port use have also been demonstrated in pediatric cancer patients, with the added advantage of allowing the child to participate in normal activities and preserving body image. 7Despite the vast experience accrued over the years and the large volume of literature studying factors associated with IVAD port outcomes, early perioperative and late postoperative complications still occur (see Table 1). 8,9 Overall complication rates for IVAD ports reportedly occur in the range from 2% to 18% of all implanted devices. 10-12Port-related infections and venous thrombosis are particularly important, because they are associated with additional morbidity and costs and require removal of the IVAD as part of their treatment in as many as 6.5% of patients. 10 An additional complication specific to the use of IVAD ports during therapeutic apheresis is the occurrence of frequent pressure-related alarms, 13-15 which do not always result in a need to abort the procedure but can delay the duration of the treatments and require additional interventions. 13Here, we present a review focused on techniques, materials, and long-term management options of ports as IVAD options that have an impact on the relevant complications and overall safety profile of th...

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Section: Catheter Materialsmentioning

confidence: 99%

Implanted vascular access device options: a focused review on safety and outcomes

Blanco-Guzman

2018

Transfusion

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“…Either excess or short of NCO group may lead to low function of the side chain extension process, making its molecular weight too large or too small to graft. Excessive amount of NCO may lead to a fast chain extension process in later stages, while shortage of NCO negatively attribute to an undesirable limit of molecular weight and viscosity in the chain extension process . As shown in Figure , the two curing temperatures of 70 and 75 °C fit within the appropriate threshold of 16% for NCO content in the later period of pre‐polymerization at six to 8 h of reaction time.…”

Section: Resultsmentioning

confidence: 73%

“…It can be seen from Figure that the concentration of NCO has a reverse relationship with time, which is mainly due to consumption of NCO by pre‐polymerization over time. Previously a threshold of 16% was reported in several works to obtain the highest performance of pre‐polymerization stage at later ages . Either excess or short of NCO group may lead to low function of the side chain extension process, making its molecular weight too large or too small to graft.…”

Section: Resultsmentioning

confidence: 99%

Synthesis and characteristics of pectiniform polyurethane‐modified polycarboxylate at room temperature

Xiang

Shi

Zhang

2017

J of Applied Polymer Sci

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In this article, modified polyurethane prepolymer was synthesized by segmental synthesis method using isophorone diisocyanate, hydroxyl‐terminated silicone, polyether glycol dimethylolpropionic acid as raw materials. After that, pectiniform polycarboxylate, of which side chains were in roughly the same polymerization degree and main chains were in different lengths, was synthesized at room temperature in initiation system of hydrogen peroxide, ascorbic acid, and persulfate. Moreover, influence of various factors on the synthesis of polyurethane‐modified polycarboxylate at room temperature was discussed in detail and optimal synthesis process was determined. Results showed that redox initiation system, increasing initiator and monomer concentration, and extending reaction time needed to be adopted to complete the reaction. However, when the reaction time was over 4 h, water reducing of polycarboxylate declined rapidly. In addition, it could be found in Fourier transform infrared spectrum analysis that the CC double bonds in acrylic acid were opened and polymerized, macromolecular chain segments were successfully connected to polyoxyethylene chain segment, and resulting polycarboxylic acid molecule contained hydroxy, carboxyl, methyl, ester group, and other groups. © 2017 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2018, 135, 45873.

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“…Arrhythmia, cardiac arrest, pulmonary embolism with hemoptysis, perforation, and thrombosis are reported. Causes of delayed failure include breakage during catheter removal, entrapment, material properties of the catheter, and long-term mechanical fatigue [60,61]. Material analysis from fractured catheters has shown an increased fracture risk with silicone catheters compared to polyurethane [60,61].…”

Section: Mechanical Failurementioning

confidence: 99%

“…Causes of delayed failure include breakage during catheter removal, entrapment, material properties of the catheter, and long-term mechanical fatigue [60,61]. Material analysis from fractured catheters has shown an increased fracture risk with silicone catheters compared to polyurethane [60,61]. Additionally, fatigue is particularly prevalent in SC catheters where mechanical shearing between the clavicle and first rib can occur [2,5,62].…”

Section: Mechanical Failurementioning

confidence: 99%

Bedside Procedure: Retained Central Venous Catheter

Cheung¹,

Mellert²,

Firstenberg³

2018

Vignettes in Patient Safety - Volume 2

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The placement of central venous catheters (CVC) is a common medical procedure and adjunct to current medical therapy. With millions of CVC placed yearly in the United States, complications occur. It is important to be aware of the potential immediate and long term complications associated with this procedure. In this chapter, a representative case of retained CVC guidewire is presented. Provider experience, appropriate patient selection and insertion technique can minimize the risk of immediate complication in most cases. A brief discussion of CVC complications with emphasis on guidewire malfunction is presented along with management and retrieval options.

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Mechanic and surface properties of central-venous port catheters after removal: A comparison of polyurethane and silicon rubber materials

Cited by 42 publications

References 24 publications

Implanted vascular access device options: a focused review on safety and outcomes

Implanted vascular access device options: a focused review on safety and outcomes

Synthesis and characteristics of pectiniform polyurethane‐modified polycarboxylate at room temperature

Bedside Procedure: Retained Central Venous Catheter

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