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再制造环形标测导管:安全性、有效性及成本

Remanufactured circular mapping catheters: safety, effectiveness and cost.

作者信息

Leung Lisa Wm, Evranos Banu, Grimster Alexander, Li Anthony, Norman Mark, Bajpai Abhay, Zuberi Zia, Sohal Manav, Gallagher Mark M

机构信息

Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust, St. George's, University of London, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK.

出版信息

J Interv Card Electrophysiol. 2019 Nov;56(2):205-211. doi: 10.1007/s10840-018-0497-x. Epub 2018 Dec 26.

Abstract

BACKGROUND

The use of remanufactured single-use devices (SUDs), including cardiac electrophysiology catheters, has become established in the USA and other health care systems but without much published scientific evaluation on the relative safety or efficacy of these devices. In the United Kingdom (UK), the use of remanufactured SUDs has not been routine. We performed a structured evaluation of the safety and efficacy of a remanufactured circular mapping catheter (Stryker® remanufactured Lasso NAV 2515) during its introduction in our centre.

METHODS

We prospectively evaluated the performance of a remanufactured circular mapping catheter in 100 consecutive patients undergoing an AF ablation. Operator feedback was obtained, assessing the device appearance, ease of use and function. As an indirect measurement of efficacy, acute procedure metrics were compared to those in 100 propensity-matched cases performed by the same operators using a new device. Cost savings were calculated.

RESULTS

No complication occurred in association with the remanufactured device. There was one reported failure of device malfunction-the flexion-extension mechanism of a remanufactured catheter and none in the matched-control group. There was satisfactory communication with the electro-anatomic mapping system. Ease of use of the remanufactured catheter was reported to be similar to a newly manufactured device. Procedural duration was similar with remanufactured devices and matched controls. With 100 cases using the remanufactured device, cost savings amounted to £30,444.

CONCLUSIONS

The use of remanufactured circular mapping catheters is safe, efficient and reliable. Widespread use of remanufactured SUDs offers the possibility of significant economic benefit.

摘要

背景

在美国和其他医疗保健系统中,包括心脏电生理导管在内的再制造一次性使用设备(SUD)的使用已得到确立,但关于这些设备的相对安全性或有效性的科学评估报道较少。在英国,再制造SUD的使用并非惯例。我们在本中心引入一种再制造的环形标测导管(史赛克®再制造Lasso NAV 2515)时,对其安全性和有效性进行了结构化评估。

方法

我们前瞻性评估了100例连续接受房颤消融术患者使用的再制造环形标测导管的性能。获取了操作人员的反馈,评估了设备外观、易用性和功能。作为疗效的间接测量指标,将急性手术指标与同一操作人员使用新设备进行的100例倾向匹配病例的指标进行了比较。计算了成本节约情况。

结果

再制造设备未发生相关并发症。有1例报告称设备出现故障——一根再制造导管的屈伸机制故障,而匹配对照组未出现此类情况。与电解剖标测系统的通信良好。据报道,再制造导管的易用性与新制造的设备相似。使用再制造设备和匹配对照组的手术时间相似。使用100例再制造设备的病例,成本节约达30444英镑。

结论

使用再制造的环形标测导管是安全、高效且可靠的。广泛使用再制造SUD有可能带来显著的经济效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd69/6848800/cb6697d4eb97/10840_2018_497_Fig1_HTML.jpg

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