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COMPLETE APPARATUS:
> Needle Guide Wire Sheath Catheter
PUNCTURE NEEDLES:
Used to cannulate or puncture the artery. Usual Sizes include
Seldinger Needle
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GUIDE WIRE:
Guide-wire structure :
Available in 35-260 cm length; should be at least 20 cm longer than the catheter to be used Majority - stainless steel (Majority coated with PTFE (Teflon) Inner core Mandrel Shaft - Coiled wire Safety ribbon / wire Extends the whole length of coil All wires have a bead at the tip - soldered.
DEFINITION:
A catheter is a hollow flexible tube that can be inserted into a body cavity, duct or vessel. Catheters thereby allow drainage or injection of fluids , distend a passageway or provide access by surgical instruments. The process of inserting a catheter is catheterization. In most uses a catheter is a thin, flexible tube: a "soft" catheter; in some uses, it is a larger, solid tube: a "hard" catheter.
Strength
Radiopacity
Flexible
Atraumatic Tip
Low Surface frictional resistance for good trackability over guide wire.
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PARTS OF A CATHETER
BODY
HUB BODY
HUB TIP
TIP
GUIDING CATHETERS
Used for Angioplasty. Guiding catheters are like angiography catheters only difference is that guiding catheters are more stiffer & firm as it carries Balloon catheters, PTCA wires and stent delivery system. Mild stiffness comes due to the wire braided design. Good Push ability .
Good Tractability.
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TYPES OF CATHETERS:
CLASSIFICATION :
Catheters can be classified depending on SIDE HOLES :
-: Single Hole
-:End Hole with side holes. -:Blocked end with side holes only.
SIZES :
Abdominal 6-80 cm Thoracic or Carotid Arteries 100-120 cm NOTE: Size depends on : > age of the patient > selective or super selective study > size of the vessels. NOTE: Ideal practice is to use the smallest diameter catheter feasible for any particular study to minimize the risk of arterial damage by the procedure.
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TYPES OF CATHETERS
SHAPES Straight Catheter
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Judkins Left
Judkins Right
Amplatz Left
Amplatz Right
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Butterfly Catheters
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Hydrophilic-coated catheters have a layer of polymer coating that is bound to the catheter surface. The polymer absorbs and binds water to the catheter, resulting in a thick, smooth and slippery surface. Intermittent Catheters: Intermittent catheters are hollow tubes used to drain urine from the bladder. Pediatric Catheters:
Usually its around 80cm.
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Catheter construction :
Single layered/Multi layered
Multi layered :
Inner tube - of Teflon / Polyurethane Middle layer - tube of nylon, woven Dacron, or stainless steel braiding. External layer - A tube of polyethylene or polyurethane is then heated and extruded over the two inner layers to bond firmly . Radio- opaque material is incorporated by impregnating with barium or bismuth Ba, Bi soften the catheter ,may produce fine pitting of surface thereby increasing thrombogenicity Thrombogenicity is reduced by coating with Silicone or any antithrmbogenic materaial
Catheters Materials
Dacron ,Polyurethane, Poly ethylene, Teflon, Polyvinylchloride (PVC)
Dacron
Eg. GL - Goodale Lubin, NIH.
Woven Dacron Most covered with polyurethane coating to increase surface stiffness and reduce vascular trauma. Some angiographic catheters are reinforced with a nylon core.
PE is relatively resistant to softening by barium/bismuth and is more easily extruded can be easily softened by heating for reshaping/special tip configurations has to be gas sterilized PU has an excellent memory. This is a desirable feature of super selective catheters whose tip design may be altered during insertion and manipulation. Softer - which reduces the risk of vascular trauma or perforation. can be reshaped by immersing in boiling water/or steam I
Teflon
Stiffest vascular catheters.
Teflon has poor catheter memory - more appropriate for non-selective catheterization. Eg. Mullins for septal puncture / all sheaths
Polyvinyl chloride
PVC
Balloon Materials
Manufacturing Balloons
Angioplasty balloons are made by extruding material into a tube shape and then forming the tube into a balloon through a process known as blow moulding. The balloon should have: The smallest possible wall thickness Burst pressure of more than 15 bar Defined pressure and diameter characteristics
from the urinary bladder as in urinary catheterization, e.g., the Foley catheter.
Administration of intravenous fluids, medication or parenteral nutrition with a peripheral venous catheter.
Angioplasty , angiography , balloon septostomy, balloon angioplasty.
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CONTD
Direct measurement of blood pressure in an artery or vein. Direct measurement of intracranial pressure. Administration of anesthetic medication into the epidural space, the subarachnoid space, or around a major nerve bundle such as the brachial plexus. Subcutaneous administration of insulin or other medications. A central venous catheter is a conduit for giving drugs or fluids into a large-bore catheter positioned either in a vein near the heart or just inside the atrium.
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REFERENCES:
Websites:
Wikipedia Google
Books:
Diagnostic and therapeutic Cardiac Catheterization : Carl J.Pepine Cardiac Catheterization Angiograhy and Instruments: W. Grossman, Donald Baim Cardiac Catheterization methods diagnostic and therapeutic: Peterson ,Nicod
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