Nakai Motoki, Saguchi Toru, Yunaiyama Daisuke, Takara Yuki, Tanaka Taro, Okada Yukinori, Saito Kazuhiro
Department of Radiology, Tokyo Medical University, Tokyo, Japan.
J Endovasc Ther. 2023 Oct 31:15266028231208652. doi: 10.1177/15266028231208652.
We have developed a new microcatheter (designated "NSX") with an outer layer of polytetrafluoroethylene (PTFE) at its tip. We compared the adhesion of the new NSX microcatheter and a conventional microcatheter with -butyl-2-cyanoacrylate (NBCA) in vitro and in swine blood vessels.
The 3 cm tip of the NSX microcatheter is composed of PTFE, which can be identified by double platinum markers. The tips of the NSX and conventional microcatheters were inserted into a vascular model filled with porcine blood with no flow, and NBCA mixed with lipiodol (1:2) was injected from the microcatheters. Two minutes after the injection of NBCA, the microcatheter was withdrawn and the degree of its adhesion to NBCA was evaluated by measuring the resistance value (N) during catheter removal with a digital force gauge. These measurements were repeated with 20 catheters of each type. Similarly, 5 injections were performed with both the NSX and conventional microcatheters in swine vessels. The degree of adhesion of the catheter and blood vessel was evaluated by 2 radiologists under X-ray fluoroscopy on a 3-point scale: 1, no adhesion; 2, mild adhesion; 3, strong adhesion.
The mean resistance values (N) for the NSX and conventional microcatheters were 0.503±0.186 and 1.051±0.367 (N), respectively (p<0.001). The NSX adhered negligibly to the NBCA and was easily removed, whereas the conventional microcatheter adhered strongly to the NBCA in the blood vessels and was difficult to remove from the swine vessels (p=0.008).
The new NSX microcatheter with a PTFE tip exhibits poorer adhesion to NBCA than do conventional microcatheters and allows for safer injection of NBCA than conventional microcatheters, without requiring immediate catheter retrieval.
The NSX microcatheter with a PTFE tip adheres less strongly to NBCA than do conventional microcatheters and allows the safe injection of NBCA. The NSX microcatheter has double platinum markers on its tip, which make it easy to distinguish the PTFE-covered region. As the NSX does not adhere firmly to the arterial wall, it is less likely to cause vascular injury during removal of the catheter compared with conventional microcatheters, so there is no need to remove the NSX immediately after injecting NBCA. Even operators unfamiliar with NBCA can use NBCA safely with this new NSX microcatheter without requiring special training or skill.
我们研发了一种新型微导管(命名为“NSX”),其尖端外层为聚四氟乙烯(PTFE)。我们在体外和猪血管中比较了新型NSX微导管和传统微导管与丁基-2-氰基丙烯酸酯(NBCA)的黏附情况。
NSX微导管3厘米长的尖端由PTFE构成,可通过双铂金标记识别。将NSX微导管和传统微导管的尖端插入充满无流动猪血的血管模型中,并从微导管注入与碘油混合(1:2)的NBCA。注入NBCA两分钟后,拔出微导管,用数字测力计测量拔管过程中的阻力值(N),以此评估其与NBCA的黏附程度。每种类型的20根导管均重复进行这些测量。同样,NSX微导管和传统微导管在猪血管中均进行5次注射。由2名放射科医生在X线透视下以3分制评估导管与血管的黏附程度:1分,无黏附;2分,轻度黏附;3分,重度黏附。
NSX微导管和传统微导管的平均阻力值(N)分别为0.503±0.186和1.051±0.367(N)(p<0.001)。NSX微导管与NBCA的黏附可忽略不计,易于拔出,而传统微导管在血管中与NBCA的黏附很强,难以从猪血管中拔出(p=0.008)。
带有PTFE尖端的新型NSX微导管与NBCA的黏附性比传统微导管差,与传统微导管相比,注射NBCA时更安全,无需立即取出导管。
带有PTFE尖端的NSX微导管与NBCA的黏附性比传统微导管弱,可安全注射NBCA。NSX微导管尖端有双铂金标记,便于区分PTFE覆盖区域。由于NSX微导管不牢固黏附于动脉壁,与传统微导管相比,拔管时引起血管损伤的可能性较小,因此注射NBCA后无需立即取出NSX微导管。即使不熟悉NBCA的操作人员使用这种新型NSX微导管也能安全使用NBCA,无需特殊培训或技能。