Thrombogenicity of angiographic catheters: Comparative and

Rheological study on human blood ex vivo in angiographic conditions.

A-L. Baillyl, A. Laurentl, G. Guiffant2, J. Dufaux2, JJ. Merlandl

1 - Lab and Dpt of Interventional Neuroradiology - Claude Bernard Research Fund - Hopital
Lariboisiere, 2 rue A Pare F-7S0 l0 Paris
2 - Lab of Biorheology and HydroPhysiology-LBHP URA CNRS 3 4 3 -Universite Paris VII Jussieu,
2 , PI Jussieu F -7S00 S Paris

Abstract- We evaluated the patterns of Six different commercially available materials

catheter thrombogenlclty by measuring the of similar diameter (SF), made from 4 different
instantaneous flow of human blood In raw materials (PA, PE , PE -PP, PebaxTM) and
anglographlc conditions on 6 different
containing 4 different colorants (carbon black,
materials. We separated groups of different
alimentary green, red and blue), were evaluated
thrombogenlclty degree. We also showed
during 30 angiographic procedures.
different thrombogenlclty behaviours
The comparative study used:
during the tubes' occlusion phenomena.
- linear regression models for parameters
related to flow reduction/time (relative flow
INTRODUCTION
rates, parameters of flow reduction slopes, time
of occlusion);
Thromboembolic complications still represent
- chi-square comparisons for categorical data
a significant risk[1][2][ 3 ] during catheterization
(occurence of occlusion, raw material.. . ).
procedures, especially in the neurological and
A rheological analysis of the sequence of the
interventional fields.
events leading to occlusion was also effected.
The purpose of this study was to evaluate the
thrombogenicity of a series of angiographic
RESULTS
catheters in contact with human arterial blood in
angiographic conditions ex vivo
The comparative study allowed us:
- to describe an initial "silent" period, during
MATERIALS AND M ETHODS
which no perceptible reduction of flow is
observed, for all samples tested.
The method, derived from the Dudley test[4],is
- to separate the materials in 3 groups of
based on the study of the patterns of the
increasing thrombogenicity according to the
instantaneous blood flow reduction directly in
decrease of the blood flow in contact with the
contact with catheters tubes, inserted in the
catheters (fig 2)
femoral artery via an introducer at the beginning
- to show the relative influence of raw
of an angiographic procedure[5] (figl ).
materials and colorants on their thrombogenicity
(fig 2). The best base materials were PE -PP and
valve system
Pebax®. PA was more thrombogenic. No definite
influence of colorants could be shown.

Fig 1: Th e blo o d f r o m t h e f e m o ral artery i s o n ly

in con tact with th e in ternal s urface o f th e catheter
tubin g (exte rnal v alv e s y s tem). F i g 2: Clas s ificati o n ( ANOYA, flo w reduction
s lo pes) of materials acco rdin g to their thr o mbo g e ­
nicity . C o lo rants are c o d e d b y letters (w, x , y , z)
0 -780 3 -078 S -2/92$0 3 . 00 ©IEEE

484
 The instantaneous study of flow evolution REFERENCES
allowed us :
- to fit the pattern of progressive occlusions [1] S. Siegelman, L. Caplan and G. Annes, "Complications of
catheter angiography", Radiology, vol 91, pp 251-253,
of the catheter tubes to a theoretical
1968
hydrodynamic model of progressive deposition
[2] G. Roberts, E. Roberts, R. Davies and B. Laurie,
[6](7J (fig 3) corresponding to the formula:
'Thrombogenicity of arterial catheters and guidewires", Br J
t..
Q= Qmax e - 4t/ . Radiol, vol 50, pp 415-418, 1977
Where Q is the flow rate, Qmax the initial [3] D. Kido, P. King, J. Manzione and J. Simon, "The role of
flow rate, t the time, and A. the time scale of the catheters and guidewires in the production of angiographic
decrease of the lumen radius. thromboembolic complications", Invest Radiol, vol 23, pp
359-365, 1988
[4] B. Dudley, J. Williams, K. Able and B. Muller, "Synthesis
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Artif Intern Organs, vol XXII, pp 538-544, 1976
[5] A. Laurent, R. Eloy and J. Merland, "Thrombogenicity of
arterial catheters depends on catheter type, not base
material", Neuroradiology, vol 33(suppl), pp 560-561, 1991
[6] G. Guiffant and J. Dufaux, "Estimation du depot d'une espece
diffusante dans un ecoulement", 1990, CNRS URA 343-
Personal Communication.
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300 360 420 480 540 600

Time (s)

f i g 3: P r o g r e s s i v e o c c l us i o n of t h e c a t h e t e r
F l o w r a t e curv e (a), b e s t c urv e f i t (b)

- to describe some curve patterns evoking

'cyclic thrombosis' with intermittent release of
small thrombi, or durable occlusion by the
release of a bigger thrombus(fig 4 )

flow

a b

time
F i g 4: E xa m p l e s o f i n i t i ally s t a b l e fl o w r a t e s
f o l l o wed b y " c y c l i c t h r o mb o s i s " (a) o r b y s udden
o c c l us i o n (b)

CONCLUSION

This model is the only available that allows a

realistic evaluation of the thrombogenic
properties of angiographic catheters on human
blood. It is also a useful tool for the study of the
rheological sequence of events during their
thrombotic occlusion.

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