TITLE:
Surface Treated Catheters for Vascular Access—Useful?
AUTHORS:
Rolf Bambauer, Ralf Schiel, Carolin Bambauer, Reinhard Latza
KEYWORDS:
Surface Treated Large Bore Catheters; Hemodialysis; Apheresis; Ion Been Assisted Deposition (IBAD); Microdomain-Structered Surface (PUR-SMA Coated Catheter)
JOURNAL NAME:
Open Journal of Nephrology,
Vol.3 No.3,
September
9,
2013
ABSTRACT:
Background:
Catheter-related infections (CRI), thrombosis, and stenosis are among the most
frequent complications associated with catheters which are inserted in vessels
as vascular access. These problems are usually related to the handling of the
staff, the catheter materials, and the surface properties of the catheter. To mitigate
such complications surface treatment process of the outer surface, such as ion
beam assisted deposition is investigated in a retrospective study from 1992 to 2007, to prove if
the surface treatment of the catheters is a sufficient solution. Methods: This
study (1992-2007) evaluated silver coated and non-coated implanted large-bore
catheters used for extracorporeal detoxification. In 159 patients, 54 patients
received a silver coated catheter (Spi-Argent, Spire Corporation, Bedford, MA,
USA) and 105 patients, an untreated catheter served as controls. The catheters were inserted
into the internal jugular or subclavian veins. After removal, the catheters were cultured for bacterial
colonization using standard microbiologic assays. They were also examined using
a scanning electron microscope (SEM). Results: The silver coated catheters
showed a tendency towards longer in situ time. The microbiologic examinations of the catheter tips were in both catheter
types high positive, but not significant. Conclusion: The silver coated catheters
showed no significant reduction in infection rate by evaluation of all
collected data in this retrospective study. There was no association between
both catheters in significantly reducing patient discomfort. Other surface treatments which include the
outer and inner surface are necessary. New developed catheter materials such as the microdomain structured
inner and outer surface, as an example, are considered more biocompatible
because they mimic the structure of natural biological surface.