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Khzam A, Saunier J, Carpentier L, Mignot A, Tortolano L, Yagoubi N. Impact of lock solutions on the mechanical performance of polyurethane central venous catheters: A comparative study. Med Eng Phys 2023; 117:103994. [PMID: 37331749 DOI: 10.1016/j.medengphy.2023.103994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/14/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023]
Abstract
The impact of ethanol locks on the mechanical performances of central venous catheters was compared to that of aqueous-based locks. Several mechanical tests were performed to evaluate catheter behavior: kinking radius measurements, burst pressure, and tensile tests. Different polyurethanes were studied to assess the impact of radio-opaque charge and polymer chemical composition on catheter behavior. The results were correlated to swelling measurements and calorimetric measurements. In particular, ethanol locks have a higher impact on long contact time than aqueous-based locks: stresses and strains at break were lower, and kinking radii were higher. However, for all catheters, the mechanical performances remain much higher than the normative requirements.
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Affiliation(s)
- Afif Khzam
- Matériaux et Santé, UFR de pharmacie, Université Paris Saclay, France
| | - Johanna Saunier
- Matériaux et Santé, UFR de pharmacie, Université Paris Saclay, France.
| | | | | | - Lionel Tortolano
- Matériaux et Santé, UFR de pharmacie, Université Paris Saclay, France; Assistance Publique-Hôpitaux de Paris, Groupe hospitalier Henri Mondor, Department of Pharmacy, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, F-94010, France
| | - Najet Yagoubi
- Matériaux et Santé, UFR de pharmacie, Université Paris Saclay, France
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Hartquist CM, Lee JV, Qiu MY, Suskin C, Chandrasekaran V, Lowe HR, Zayed MA, Osbun JW, Genin GM. Stability of navigation in catheter-based endovascular procedures. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.02.543219. [PMID: 37333419 PMCID: PMC10274636 DOI: 10.1101/2023.06.02.543219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Endovascular procedures provide surgeons and other interventionalists with minimally invasive methods to treat vascular diseases by passing guidewires, catheters, sheaths and treatment devices into the vasculature to and navigate toward a treatment site. The efficiency of this navigation affects patient outcomes, but is frequently compromised by catheter "herniation", in which the catheter-guidewire system bulges out from the intended endovascular pathway so that the interventionalist can no longer advance it. Here, we showed herniation to be a bifurcation phenomenon that can be predicted and controlled using mechanical characterizations of catheter-guidewire systems and patientspecific clinical imaging. We demonstrated our approach in laboratory models and, retrospectively, in patients who underwent procedures involving transradial neurovascular procedures with an endovascular pathway from the wrist, up in the arm, around the aortic arch, and into the neurovasculature. Our analyses identified a mathematical navigation stability criterion that predicted herniation in all of these settings. Results show that herniation can be predicted through bifurcation analysis, and provide a framework for selecting catheter-guidewire systems to avoid herniation in specific patient anatomy.
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Guerreiro H, Schröder H, Huber G, Busch F, Sellenschloh K, Adam G, Ittrich H, Busch JD. Quantification of mechanical properties in long-term in vivo used silicone catheter lines according to DIN 10555-3. Clin Biomech (Bristol, Avon) 2023; 107:106015. [PMID: 37321163 DOI: 10.1016/j.clinbiomech.2023.106015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Totally implantable central venous access port devices are crucial for intravenous application of chemotherapeutics and long-term therapy for chronic disease. Common complications include thrombosis and device fracture related to altered material properties through exposure in situ. This study exhibits whether uniaxial tensile properties (DIN 10555-3) of in vivo used catheters prove inferior to unused catheters. MATERIAL AND METHODS 5 unused, originally packed silicone catheters were cut into 6 segments of 50 mm: 3 segments each were cleaned via cleaning solution (n = 15) while 3 segments were left unattended (n = 15). Distal segments (50 mm) of long-term in vivo used silicone catheters were cleaned before testing (n = 33). Overall mechanical behavior was tested in a custom-made self-centering, torsion free carrier. Maximum force stress at failure, strain at failure and Young's modulus were determined and statistically analyzed. FINDINGS Unused catheters showed no significant difference in testing. in vivo used catheters exhibited 20% lower maximal force than unused catheters (p < 0.001), strain at break (p 〈0,001), and 7% higher elastic modulus (p = 0.004; power: 0.845). Due to a constant cross section area, stress at failure was proportional to maximum force (p < 0.001). Relation between determined parameters and dwell times was non-significant. INTERPRETATION In vivo long-term used silicone catheters showed significantly lower ultimate strength than unused ones. It is likely that in situ altering changes the mechanical properties of catheters and may potentially lead to failure.
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Affiliation(s)
- H Guerreiro
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - H Schröder
- Institute of Biomechanics TUHH Hamburg University of Technology, Hamburg, Germany
| | - G Huber
- Institute of Biomechanics TUHH Hamburg University of Technology, Hamburg, Germany
| | - F Busch
- Division of Neonatology, Department of Pediatrics Bern University Hospital, University of Bern, Switzerland
| | - K Sellenschloh
- Institute of Biomechanics TUHH Hamburg University of Technology, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Ittrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J D Busch
- Department of Diagnostic, Interventional Radiology and Pediatrics Bern University Hospital, University of Bern, Switzerland
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Khzam A, Saunier J, Carpentier L, Mignot A, Tortolano L, Yagoubi N. Surface and mechanical properties of polyurethane central venous catheters after repeated contact with chemotherapy excipient solutions. J Biomed Mater Res B Appl Biomater 2023; 111:1182-1196. [PMID: 36705442 DOI: 10.1002/jbm.b.35224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/05/2022] [Accepted: 12/23/2022] [Indexed: 01/28/2023]
Abstract
This article investigates the impact of the interactions between polyurethane central venous catheters and solutions containing excipients used in cisplatin and paclitaxel formulations. Changes to the properties of catheters and the leaching of catheter additives into the infused solutions were studied while these solutions were infused cyclically for several months. Chemotherapy treatment was mimicked in vitro in compliance with hospital practices. The treatment cycle was repeated 10 times, using solutions containing only the excipients. After 10 treatment cycles, no physical or chemical degradation of the catheter was observed. Mechanical performances were stable, but surface modifications occurred, causing the surface to become more hydrophobic. A loss in polyurethane antioxidant amount was observed in part due to a leaching phenomenon.
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Affiliation(s)
- Afif Khzam
- Matériaux et Santé, UFR de pharmacie, Université Paris-Saclay, Orsay, France
| | - Johanna Saunier
- Matériaux et Santé, UFR de pharmacie, Université Paris-Saclay, Orsay, France
| | | | | | - Lionel Tortolano
- Matériaux et Santé, UFR de pharmacie, Université Paris-Saclay, Orsay, France.,Department of Pharmacy, Assistance Publique-Hôpitaux de Paris, Groupe hospitalier Henri Mondor, Créteil, France
| | - Najet Yagoubi
- Matériaux et Santé, UFR de pharmacie, Université Paris-Saclay, Orsay, France
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Saunier J, Khzam A, Yagoubi N. Impact of mechanical stress on flexible tubing used for biomedical applications: Characterization of the damages and impact on the patient's health. J Mech Behav Biomed Mater 2022; 136:105477. [PMID: 36219992 DOI: 10.1016/j.jmbbm.2022.105477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022]
Abstract
Flexible tubing is a key part of a lot of medical devices used in hospital, but may be subjected to a lot of various mechanical stresses that can led to the failure or to complications for the patients. The nature and causes of these mechanical stresses were listed for peristaltic pump tubing, infusion set tubing and catheters. Their consequences in term of tubing damages and particular contamination were reported. The impact of the chemical nature of the tubing, of its size and also the impact of various parameters of the clinical acts were reviewed. Last the consequences for the patient's health were discussed.
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Affiliation(s)
- J Saunier
- Matériaux et Santé, Faculté de pharmacie, Université Paris Saclay, France.
| | - A Khzam
- Matériaux et Santé, Faculté de pharmacie, Université Paris Saclay, France
| | - N Yagoubi
- Matériaux et Santé, Faculté de pharmacie, Université Paris Saclay, France
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Domsta V, Seidlitz A. 3D-Printing of Drug-Eluting Implants: An Overview of the Current Developments Described in the Literature. Molecules 2021; 26:4066. [PMID: 34279405 PMCID: PMC8272161 DOI: 10.3390/molecules26134066] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/15/2023] Open
Abstract
The usage of 3D-printing for drug-eluting implants combines the advantages of a targeted local drug therapy over longer periods of time at the precise location of the disease with a manufacturing technique that easily allows modifications of the implant shape to comply with the individual needs of each patient. Research until now has been focused on several aspects of this topic such as 3D-printing with different materials or printing techniques to achieve implants with different shapes, mechanical properties or release profiles. This review is intended to provide an overview of the developments currently described in the literature. The topic is very multifaceted and several of the investigated aspects are not related to just one type of application. Consequently, this overview deals with the topic of 3D-printed drug-eluting implants in the application fields of stents and catheters, gynecological devices, devices for bone treatment and surgical screws, antitumoral devices and surgical meshes, as well as other devices with either simple or complex geometry. Overall, the current findings highlight the great potential of the manufacturing of drug-eluting implants via 3D-printing technology for advanced individualized medicine despite remaining challenges such as the regulatory approval of individualized implants.
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Affiliation(s)
- Vanessa Domsta
- Department of Biopharmacy and Pharmaceutical Technology, Institute of Pharmacy, University of Greifswald, Center of Drug Absorption and Transport, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Anne Seidlitz
- Department of Biopharmacy and Pharmaceutical Technology, Institute of Pharmacy, University of Greifswald, Center of Drug Absorption and Transport, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
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Hartquist CM, Chandrasekaran V, Lowe H, Leuthardt EC, Osbun JW, Genin GM, Zayed MA. Quantification of the flexural rigidity of peripheral arterial endovascular catheters and sheaths. J Mech Behav Biomed Mater 2021; 119:104459. [PMID: 33887627 DOI: 10.1016/j.jmbbm.2021.104459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/28/2021] [Accepted: 03/10/2021] [Indexed: 11/18/2022]
Abstract
Endovascular catheter-based technologies have revolutionized the treatment of complex vascular pathology. Catheters and endovascular devices that can be maneuvered through tortuous arterial anatomy have enabled minimally invasive treatment in the peripheral arterial system. Although mechanical factors drive an interventionalist's choice of catheters and sheaths, these decisions are mostly made qualitative and based on personal experience and procedural pattern recognition. However, a definitive quantitative characterization of endovascular tools that are best suited for specific peripheral arterial beds is currently lacking. To establish a foundation for quantitative tool selection in the neurovascular and lower extremity peripheral arterial beds, we developed a nonlinear beam theory method to quantify catheter and sheath flexural rigidity. We applied this assessment to a sampling of commonly utilized commercially available peripheral arterial catheters and sheaths. Our results demonstrated that catheters and sheaths adopted for existing practice patterns to treat peripheral arterial disease in the lower extremities and neurovascular system have different but overlapping ranges of flexural rigidities that were not sensitive to luminal diameters within each procedure type. Our approach provides an accurate and effective method for characterization of flexural rigidity properties of catheters and sheaths, and a foundation for developing future technologies tailored for specific peripheral arterial systems.
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Affiliation(s)
- Chase M Hartquist
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA; Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Vinay Chandrasekaran
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA; Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Halle Lowe
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA; Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Eric C Leuthardt
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA; Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joshua W Osbun
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Guy M Genin
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA; Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Mohamed A Zayed
- Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri, USA; McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA; Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
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