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[Aortic wall injury and thrombogenesis in catheterization: experimental study]
Insights
Arterial catheterization can cause dangerous thrombus formation. This study shows non-heparin coated catheters damage the aorta, leading to mural thrombi and potential dissection.
Area of Science:
- Cardiovascular Medicine
- Biomaterials Science
- Medical Device Engineering
Context:
- Arterial and venous catheterization are crucial for diagnosing heart conditions.
- Catheter use is associated with thrombogenesis complications.
- Mikaelson-type non-heparin-coated angiographic catheters were investigated.
Purpose:
- To investigate the thrombogenic potential and aortic wall damage caused by two types of non-heparin-coated angiographic catheters.
- To compare polyurethane (PUC) and polyethylene (PEC) catheters regarding thrombus formation and injury.
- To evaluate the histological and ultrastructural changes in the aorta following catheterization.
Summary:
- Non-heparin-coated polyurethane (PUC) and polyethylene (PEC) catheters (6.5 Fr, 80 cm) were inserted into the ascending aorta of dogs via the femoral artery.
- Mural thrombi were observed on the aortic wall in all dogs after catheter removal.
- Microscopic analysis revealed endothelial cell detachment, internal elastic membrane destruction, intimal tears, and bleeding, indicating mechanical injury from the catheter.
Impact:
- Catheter-induced mechanical irritation can lead to significant aortic wall damage.
- This damage, including mural thrombus formation, may progress to aortic dissection or thrombosis in abdominal organs.
- Findings highlight the risks associated with non-heparin-coated catheters and the need for improved biomaterials or techniques.
Abstract:
Arterial and venous catheterization is a very useful procedure in the diagnosis of heart diseases. However, some complications with thrombogenesis have been reported. Two kinds of Mikaelson-type non-heparin-coated angiographic catheters (with 6.5 Fr. and 80 cm length) were used for the experiments. One was of polyurethane (PUC) and the other of polyethelene (PEC). Eight experimental dogs were used for each group. The catheter was inserted into the ascending aorta through the femoral artery. No antithrombogenic drugs were given to the animal. One hour later, sodium heparin (100 U/kg) was administered intravenously. The animal was sacrificed by acute exanguination. The aorta was opened longitudinally. The position of the thrombi on the aortic wall was macroscopically observed and the weight of the thrombi attached to the catheters were measured. A piece of the aorta at each level was excised for light and scanning electron microscopic observations. Mural thrombi of various lengths still remained on the aortic wall of every dog after the removal of the catheters. Microscopic observation revealed that the mural thrombus was formed on the aortic wall, where the endothelial cells had peeled off and the internal elastic membrane was partially destroyed. SEM observation also showed that fibrin network on the aortic wall where the endotherial cells were peeled off. Microscopic observation of aortic wall also revealed intimal tears, inner elastic membrane injury and bleeding in the elastic membrane. This damage could worsen leading to dissection of the aorta, thrombosis of the abdominal organs. The injury is considered due to mechanical irriation by the catheter.(ABSTRACT TRUNCATED AT 250 WORDS)