Intervention: Nanotechnology in Reconstructive Intervention and Surgery
Harry F. Tibbals in Medical Nanotechnology and Nanomedicine, 2017
A catheter is any small tube that is inserted into the body for medical purposes, such as to provide a route for drainage from a blocked cavity. Catheters are used in trauma and urological procedures, where prevention of infection is a primary concern. Antimicrobial silver nanoparticle coatings have recently been developed to prevent introduction of infection in catheters. The silver nanoparticles are produced by a proprietary process and do not require a binder, since the nanoparticles adhere to the catheter material by means of surface forces [108]. Catheters can also be used for diagnostic and treatment procedures as probes and carriers for very small surgical and imaging instruments. The Swan-Ganz catheter is inserted into the pulmonary artery to monitor critical heart functions, for example. Instruments and procedures have been developed for insertion of catheters into blood vessels and the heart, where they can deliver imaging enhancement agents, drugs, or electrical stimulation. Vascular catheters can also be tipped with ablative tools, balloons, or stents to clear blocked vessels. Miniaturization of transducers has made possible catheters equipped to deliver laser, radiofrequency, or ultrasonic ablative energy to remove plaques, clots, or other obstructions [109-112]. Percutaneous procedures are widely used in cardiac catheterization, where they can be monitored by x-ray imaging in real time for angiography (imaging of the blood vessels). Coronary angioplasty, in which arteries are cleared of obstructions, and insertion of stents to keep arteries from re-closing (restenosis) are two of the most common medical procedures performed in the United States.
Other devices and how to use them
Peter A. Schneider in Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery, 2019
The operator has the ability to adjust the throws of the needle so that they are only as deep as appears to be necessary based on the thickness of the tissue and the distance required. This is done primarily by the feel of the device and the experience of the operator. There are several similarities with the mechanism of the Pioneer Plus catheter. It is about the same size and relies on the orientation and manual advancement of a hypotube needle under visualization. Advantages of the Pioneer Plus catheter include: the distance of the throw of the needle is adjusted through a mechanism on the handle of the catheter; the turning of the catheter with the needle toward the true lumen is performed with guidance by IVUS. This makes the two-dimensional fluoroscopic image much less important for orientation and also helps decrease the number of throws of the needle that are typically required. Although the Pioneer Plus catheter is more expensive and requires availability of IVUS, the ability to place the needle accurately at the selected re-entry site and with fewer attempts is an advantage. For both devices, once the internal 0.014-inch diameter guidewire has been advanced into the true lumen, its location in the lumen is confirmed by the fact that it passes easily into the existing arterial anatomy. Usually, it is best to advance the wire as far into the true lumen as it will easily go. At that point the needle is withdrawn so that it is no longer protruding from the catheter head. The catheter is then carefully removed, with attention paid to the integrity of the wire to avoid kinking or bending or partial withdrawal of the wire. Once this is done, it is usually best to advance a balloon that is compatible with a 0.014-inch diameter guidewire to create more space along the occlusion and also at the junction where the passage has been made from false lumen to true lumen. After this, the reconstruction can be done over the 0.014-inch diameter guidewire or the wire can be exchanged for a larger caliber wire before proceeding to definitive therapy.
Definitions
Mari Robbins, Janet Wetherfield, Anthony Yates in Terminology for Medical Administrators, 2017
cardiac pertaining to the heart, cardiac arrest complete cessation of the heart’s activitycardiology study of the heart, cardiologist heart specialistcardiovascular system (CVS) body system consisting of the heart, arteries and veins; see page 9. carpal bones wrist bones; see also metacarpals and phalanges. carpal tunnel syndrome pain caused by pressure of the inflamed median nerve in the wrist and hand; common during pregancy, and for those suffering forms of arthritis and diabetescartilage a dense connective tissue in the joints, discs between vertebrae, ribs, larynx, trachea, ears and nose; capable of withstanding pressure; some is elastine for flexibilitycasualty person injured in accident or warcasualty department part of a hospital where casualties are treated, now more commonly known as an accident and emergency departmentcataract partial or complete opacity of the lens in the eye, causing blurring of sight and eventually blindness; may be senile, congenital, traumatic or associated with diabetes, and is operablecatarrh excessive secretions from the mucous lining of the nose and throat, commonly associated with a cold or chronically with enlarged adenoidscatheterization the passing of a catheter (small tube) into the body, usually into the bladder for urine drainage in cases of retention; or into the heart via the veins for pressure measurement and to take blood samplescatheter specimen of urine (CSU) sterile sample obtained to test for excess of a substance which might indicate disease: tests are Albustix or Utristix for protein, Clinitest for sugar, Haemastix for blood, and Labstix or Multistix for various substances, midstream specimen of urine (MSU) specimen of urine obtained from midstreamcellulite lumping of fatty tissue causing puckering of the skin, especially on women’s hips and thighs, cellulitis inflammation of subutaneous tissue (under the skin surface)central nervous system (CNS) the brain and spinal cord; see page 16central venous pressure measurement of blood pressure in the superior vena cava (vein entering the heart), via a catheter introduced into a vein in the arm and passed through the system of veins; low pressure may result from dehydration or haemorrhage, and high pressure from heart failurecerebellum the part of the brain that controls the co-ordination of muscle activity; see page 16cerebral palsy congenital, non-progressive brain damage resulting in varying degrees of spasticity (paralysis, spasms or inability to control muscles in the limbs)cerebrovascular accident (apoplexy, stroke) interference with blood flow into the brain; extent of damage varies, may result in local paralysis depending on site in the brain affected. Causes are: haemorrhage bursting of small blood vessel in the brain; embolism blocking of a blood vessel by a fatty deposit or air; thrombosis blocking of a vessel by a blood clotcerebrum the part of the brain that controls conscious acts; see page 16cervical cytology (smear) removal of cells from the cervix (neck of the womb) to detect abnormal (pre-cancerous) cells and other conditions; test generally performed every three years on sexually active women
A Simplified Method for Continuous Hepatic Arterial Port-Catheter System Placement Not Requiring Catheter End-Hole Occlusion
Published in Acta Radiologica, 2006
T. Yamagami, T. Kato, T. Hirota, R. Yoshimatsu, T. Matsumoto, T. Nishimura
Purpose: To evaluate the efficacy of hepatic port-catheter system placement without distal catheter tip occlusion or gastroduodenal artery embolization distal to the catheter tip. Material and Methods: A port-catheter system was percutaneously implanted in 29 patients (16 men, 13 women; mean age 65.6 years) with unresectable liver cancer. Persistent blood flow through the end hole of the catheter was verified immediately and 1–10 days after catheter placement. Results: In all cases, percutaneous port-catheter placement was successfully performed. In seven of 29 (24.1%) patients, flow through the end hole of the catheter was verified immediately after the procedure. However, no flow was seen 1–10 days after the procedure. Conclusion: It is not necessary to occlude the end hole of the catheter tip and embolize the gastroduodenal artery beyond the catheter tip when placing a port-catheter system for repeated hepatic arterial infusion chemotherapy.
Catheter manipulation training system based on quantitative measurement of catheter insertion and rotation
Published in Advanced Robotics, 2014
Hirokatsu Kodama, Chaoyang Shi, Masahiro Kojima, Seiichi Ikeda, Fumihito Arai, Ikuo Takahashi, Makoto Negoro, Toshio Fukuda
How to preserve the catheter without any modifications and improve the precision of manipulation in the catheter-based endovascular intervention remains a challenge for quantitative training and evaluation. This paper presents an optical sensor unit to measure catheter motions based on the working principle of Laser Doppler, which allows for catheter motion measurement with non-contact detection and supports medical training and evaluation without modifications on the catheter. Then, calibrate this sensor unit and implement recording of catheter motion. Next, propose a training system by tracking the reference trajectory based on an expert’s skill, and provide visual feedback to improve the precision of catheter manipulation. Eight subjects were trained for catheter manipulation with this system. Among them, six subjects improved their catheter manipulation of linear motion, and seven improved the catheter rotational motion.
Evaluation of Different Catheter Parts for Identification of Pulmonary Artery Catheter Colonisation
Published in Scandinavian Journal of Infectious Diseases, 1991
Jordi Rello, Pere Coll, Alvar Net, Guillem Prats
A prospective study was conducted over 18 months to evaluate the accuracy of the semiquantitative culture technique performed from different catheter parts for detection of catheter colonisation in critically ill patients with pulmonary artery catheters. Semiquantitative culture of the tip catheter segment alone detected 66% of catheter colonisations. Semiquantitative culture of the other intravascular catheter segments (atrial or intradermal) provided similar yield. A combination of intradermal and atrial or tip catheter segment cultures provided the best means of detecting catheter colonisation.