RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0040-1708570
Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure
![](https://www.thieme-connect.de/media/10.1055-s-00033348/202001/lookinside/thumbnails/10-1055-s-0040-1708570_00048-1.jpg)
Abstract
Objective Efficient flow of fluids through drainage/infusion catheters is affected by surrounding tissue, organ compression, and scar tissue development, limiting or completely obstructing flow through drainage holes. In this work, we introduce a novel three-dimensional (3D) drainage catheter with protected side holes to reduce flow blockages. We then compare its drainage performance to standard straight and pigtail catheters using computer-generated catheter designs and flow analysis software.
Methods Drainage performance was computed as flow rate through the catheter for a given pressure differential. Each catheter contained drainage holes on the distal (insertion) end and a single outlet (hub) hole open to atmosphere. Computational fluid dynamics using ANSYS AIM 18.2 was used to simulate flow through the catheter and examine drainage performance based on variations to the following parameters: (1) side hole shape, (2) cross-sectional area of the catheters, (3) number of side holes, and (4) cross-sectional area of the side holes.
Results Drainage through the newly introduced catheter in all simulations was nearly identical to standard pigtail and straight catheters. While working to optimize the 3D catheter design, we found that the changes in side hole shape and side hole cross-sectional area had little effect on the total flow rate through the catheters but had a large impact on flow rate through the side hole nearest to the hub (proximal hole). Additionally, the majority of flow in all catheters occurred at the most proximal 1 to 3 side holes closest to hub, with relatively little flow occurring at side holes more distally located (closest to insertion end). The 3D catheter demonstrated no changes in flow characteristics when the coiled segment was occluded, giving it an advantage over other catheter types when the catheter is compressed by surrounding tissue or other external obstruction.
Conclusions The majority of fluid flow in catheters with a diameter of 4.67 mm (14 Fr) or smaller occurred at the most proximal 1 to 3 side holes. A novel 3D coiled catheter design can protect these proximal holes from external blockage while maintaining drainage performance compared with standard straight and pigtail catheters.
* M.B. and B.F. contributed equally to this work and should be considered co-first authors.
Publikationsverlauf
Artikel online veröffentlicht:
29. April 2020
© .
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Levin DC, Eschelman D, Parker L, Rao VM. Trends in use of percutaneous versus open surgical drainage of abdominal abscesses. J Am Coll Radiol 2015; 12 (12, Pt A) 1247-1250
- 2 Gervais DA, Brown SD, Connolly SA, Brec SL, Harisinghani MG, Mueller PR. Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics 2004; 24 (03) 737-754
- 3 Alvino DML, Fong ZV, McCarthy CJ. et al. Long-term outcomes following percutaneous cholecystostomy tube placement for treatment of acute calculous cholecystitis. J Gastrointest Surg 2017; 21 (05) 761-769
- 4 Duszak Jr R, Behrman SW. National trends in percutaneous cholecystostomy between 1994 and 2009: perspectives from Medicare provider claims. J Am Coll Radiol 2012; 9 (07) 474-479
- 5 Rotman JA, Getrajdman GI, Maybody M. et al. Effect of abdominopelvic abscess drain size on drainage time and probability of occlusion. Am J Surg 2017; 213 (04) 718-722
- 6 Mueller PR, van Sonnenberg E, Ferrucci Jr JT. Percutaneous biliary drainage: technical and catheter-related problems in 200 procedures. AJR Am J Roentgenol 1982; 138 (01) 17-23
- 7 Huang SY, Engstrom BI, Lungren MP, Kim CY. Management of dysfunctional catheters and tubes inserted by interventional radiology. Semin Intervent Radiol 2015; 32 (02) 67-77
- 8 Kehrer J, Hauser H. Visualization and visual analysis of multifaceted scientific data: a survey. IEEE Trans Vis Comput Graph 2013 19 (03) 495-513
- 9 Ong C, Xiong F, Kabinejadian F. et al. Hemodynamic analysis of a novel stent graft design with slit perforations in thoracic aortic aneurysm. J Biomech 2019; 85: 210-217
- 10 Galarza M, Giménez A, Pellicer O, Valero J, Amigó JM. Parametric study of ventricular catheters for hydrocephalus. Acta Neurochir (Wien) 2016; 158 (01) 109-115, discussion 115–116
- 11 Ballard DH, Flanagan ST, Li H, D’Agostino HB. In vitro evaluation of percutaneous drainage catheters: Flow related to connections and liquid characteristics. Diagn Interv Imaging 2018; 99 (02) 99-104
- 12 Macha DB, Thomas J, Nelson RC. Pigtail catheters used for percutaneous fluid drainage: comparison of performance characteristics. Radiology 2006; 238 (03) 1057-1063
- 13 Reinhart WH, Näf G, Werth B. Viscosity of human bile sampled from the common bile duct. Clin Hemorheol Microcirc 2010; 44 (03) 177-182
- 14 Ooi RC, Luo XY, Chin SB, Johnson AG, Bird NC. The flow of bile in human cystic duct. J Biomech 2004; 37 (12) 1913-1922
- 15 Tanaka M, Ikeda S, Nakayama F. Change in bile duct pressure responses after cholecystectomy: loss of gallbladder as a pressure reservoir. Gastroenterology 1984; 87 (05) 1154-1159
- 16 Steiner LA, Andrews PJ. Monitoring the injured brain: ICP and CBF. Br J Anaesth 2006; 97 (01) 26-38
- 17 Winbladh A, Gullstrand P, Svanvik J, Sandström P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB (Oxford) 2009; 11 (03) 183-193
- 18 Bauman ZM, Kulvatunyou N, Joseph B. et al. A prospective study of 7-year experience using percutaneous 14-french pigtail catheters for traumatic hemothorax/hemopneumothorax at a level-1 trauma center: size still does not matter. World J Surg 2018; 42 (01) 107-113
- 19 Beland MD, Patel L, Ahn SH, Grand DJ. Image-guided cholecystostomy tube placement: short- and long-term outcomes of transhepatic versus transperitoneal placement. AJR Am J Roentgenol 2019; 212 (01) 201-204
- 20 Teoh AYB, Serna C, Penas I. et al. Endoscopic ultrasound-guided gallbladder drainage reduces adverse events compared with percutaneous cholecystostomy in patients who are unfit for cholecystectomy. Endoscopy 2017; 49 (02) 130-138
- 21 Radtke J, Schild R, Reismann M. et al. Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: a comparative data analysis from a transplant surgical and a pediatric surgical department. J Pediatr Surg 2018; 53 (04) 640-643