Four incidents of catheter separation in three patients during left heart cath eterization and coronary angiography are presented. In two cases the catheters had been used before. After the second incident, we decided to use angiography catheters once only.
All catheter fragments were removed under local anesthesia, and no further complications arose. In all incidents the point of catheter fracture was near the bond between the body of the catheter and its tip.
We believe that catheter separation is related to polymer aging. The cathe ters in the third and fourth incidents were unused, but there was no expiration date on their packages.
We recommend that (1) expiration dates be clearly stated on every catheter package, (2) catheter manufacturers issue warnings not to use catheters after expiration date, and (3) unused angiography catheters with no expiration date not be used. We also suggest that consideration be given to using catheters once only.
Get full access to this article
View all access options for this article.
References
1.
Schneider RM et al: Fracture of a polyurethane cardiac catheter in the aortic arch: A complication related to polymer aging. Cathet Cardiovasc Diagn9:197-207, 1983.
2.
Gordon DH, Glanz S., Sclafani Sja: Prevention of embolization of a catheter fragment to the lower extremity by compression of the femoral artery. Cardiovasc Intervent Radiol5:117-118, 1982.
3.
Reddy Cvr et al: Catheter separation during coronary angiography. Cathet Cardiovasc Diagn9:417-419, 1983.
4.
Aldridge HE, Lee J.: Transvascular removal of catheter fragments from the great vessels of the heart. Can Med Assoc117: 1300-1304, 1977 .
5.
Lassers BW, Pickering D.: Removal of an iatrogenic foreign body from the aorta by means of a ureteric stone catheter. Am Heart J73:375-378, 1967.
6.
Curry JL: Recovery of detached intravascular catheter or guide wire fragments. A proposed method. Am J Roentgenol105:894-896, 1969.
7.
Weinshelbaum A., Carson SN: Separation of angiographic catheter during arteriography through vascular grafts. Am J Radiol134:583-584, 1980.
8.
Feigenbaum L. , Grollman JH: Catheter separation in aortofemoral grafts despite guide wire protection. Am J Radiol134:581-582, 1980.
9.
Mirhoseini M. , O'Connor TM, Weisel W.: Embolic catheter removal from pulmonary artry . JAMA202:73, 1967.
10.
Mariano BP, Roper CL, Staple TW: Accidental migration of an intravenous infusion catheter from the arm to the lung. Radiology86:736-738, 1966.
Seldinger SI : Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta Radiol39:368, 1953.
13.
Sones FM, Shirey EK: Line coronary arteriography. Mod ConceptsCardiovasc Dis31:735, 1962.
14.
Schwartz WB : The regulation strategy for controlling hospital costs. Problems and prospects. N Engl J Med305:1249-1255, 1981.
15.
Eisenberg JM , Williams SV: Cost containment and changing physicians' practice behavior. Can the fox learn to guard the chicken coop?JAMA246:2195-2201, 1981.
16.
Reinhart UE : Future trends in the economics of medical practice and care. Am J Cardiol56:50C-59C, 1985.
17.
Boal BH et al: Report of the policy conference on pacemakers reuse. Sponsored by the North American Society of Pacing and Electrophysiology. JACC5:808-810, 1985.
18.
Ravin CE, Koehler PR: Reuse of disposable catheters and guide wires. Radiology122:577-579, 1977.
19.
Fisher RG, Ferreyro R.: Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies. Am J Roentgenol130:541-548, 1978.
20.
Bloomfield DA: Techniques of nonsurgical retrieval of iatrogenic foreign bodies from the heart. Am J Cardiol27:538-545, 1971.
21.
Dotter CT, Rösch J., Bilbao MK: Transluminal extraction of catheter and guide fragments from the heart and great vessels; 29 collected cases. Am J Roentgenol111:467-472, 1972.
