University of Minnesota, Minneapolis, Minnesota, USA.
J Urol. 2011 Dec;186(6):2307-9. doi: 10.1016/j.juro.2011.07.080. Epub 2011 Oct 20.
We compared the efficiency of clearance of a simulated clot from a bladder model using a 6-hole irrigation catheter, a traditional Malecot catheter and a modified Malecot catheter with additional side holes.
Latex balloons 12 inches in diameter served as the bladder model. They were filled with 300 cc Jell-O® gelatin, which had been partially solidified for 8 hours at 36F. Five manual irrigation/aspiration cycles with a 60 cc catheter tip syringe were performed to remove simulated clot from the bladder models and the amount of clot removed was measured. Five bladder models were used to test the efficiency of clot removal for each 22Fr catheter design, including a standard 22Fr Model 361222 Malecot latex 4-wing catheter (Rusch, High Wycombe, United Kingdom) and a 22Fr Bardex® Model 606118-22 latex 6-hole catheter. Two modified versions of the Malecot catheter design involving 2 and 4 additional holes were also tested to determine the effect of a hybrid 6-hole/Malecot design.
The 6-hole catheter was more efficient for clot evacuation than the Malecot catheter (p = 0.014). The modified Malecot catheter with 4 additional holes was more efficient than the original Malecot catheter (p = 0.020). However, it was not significantly better than the 6-hole catheter. After 5 irrigation/aspiration cycles 77.0% of residual clot remained in the bladder with the Malecot catheter compared to 60.4% and 54.0% for the 6-hole and modified 4-hole Malecot catheters, respectively.
The 6-hole catheter showed an advantage in clot removal over the Malecot catheter design. The enhanced ability of the 6-hole design to remove simulated clot may be attributable to the larger area covered by the holes at the catheter tip. Further investigation to determine the effect of spacing between the holes and the number of holes on the ability to break apart and remove clot is recommended for a more thorough understanding of differences among catheter models and methods of improvement.
我们比较了使用 6 孔灌洗导管、传统 Malecot 导管和改良后的 Malecot 导管(带有额外侧孔)从膀胱模型中清除模拟血块的效率。
直径 12 英寸的乳胶气球作为膀胱模型。它们充满了 300cc 的 Jell-O®明胶,在 36°F 下已部分凝固 8 小时。使用 60cc 导管尖端注射器进行 5 次手动冲洗/抽吸循环,以从膀胱模型中清除模拟血块,并测量清除的血块量。每个 22Fr 导管设计使用 5 个膀胱模型进行血块清除效率测试,包括标准的 22Fr 型号 361222 Malecot 乳胶 4 翼导管(Rusch,英国海威科姆)和 22Fr Bardex® 型号 606118-22 乳胶 6 孔导管。还测试了两种改良的 Malecot 导管设计,分别涉及 2 个和 4 个额外的孔,以确定混合 6 孔/Malecot 设计的效果。
6 孔导管在清除血块方面比 Malecot 导管更有效(p=0.014)。带有 4 个额外孔的改良 Malecot 导管比原始 Malecot 导管更有效(p=0.020)。然而,它并不比 6 孔导管好很多。经过 5 次冲洗/抽吸循环,与 Malecot 导管相比,膀胱中仍有 77.0%的残余血块,而 6 孔导管和改良的 4 孔 Malecot 导管分别为 60.4%和 54.0%。
6 孔导管在清除血块方面优于 Malecot 导管设计。6 孔设计增强了清除模拟血块的能力,这可能归因于导管尖端孔的更大面积。为了更深入地了解导管模型和改进方法之间的差异,建议进一步研究孔之间的间距和孔的数量对分离和清除血块的能力的影响。