Catheterization, Central Venous ; adverse effects ; instrumentation ; Catheters, Indwelling ; adverse effects ; Central Venous Catheters ; adverse effects ; Device Removal ; Humans

With the vigorous development of medical device manufacturing industry in China, anesthetic puncture bag has been completely localization. The extensive application of anesthesia technology and the subsequent adverse events of anesthesia catheter rupture have been reported frequently. This paper attempts to explore and think about the harm and countermeasures of epidural anesthesia catheter fracture from the point of view of medical device supervision.
Anesthesia, Epidural ; Catheterization ; Catheters/adverse effects* ; China ; Humans ; Rupture

OBJECTIVETo explore the clinical efficacy and safety of the early use of urokinase in the prevention and treatment on tunneled hemodialysis catheter related fibrin sheaths.

METHODSThirty-eight hemodialysis patients with tunneled central venous catheter and good catheter function were randomly divided into experimental group and control group. Urokinase was given after 3 days of indwelling catheter in the experimental group and after the onset of catheter dysfunction in the control group. The catheter function, mean blood flow and venous pressure of dialysis, coagulation, and side effects in the two groups were observed for 6 months.

RESULTSThe rates of catheter dysfunction on the arterial side were 0.65% and 2.71% in the experimental group and control group, respectively (P<0.05), with catheter dysfunction rates on the vein side of 0.92% and 2.41%, respectively (P<0.05). Catheter dysfunction occurred for the first time at 87.9 ± 24.1 days in the experimental group, and at 31.3 ± 11.5 days in the control group (P<0.05). The mean blood flow showed no significant difference between the two groups at 1 month after tube insertion (P>0.05), but was higher in the experimental group at 3 and 6 months after the tube insertion (P<0.05). The mean venous pressure in two groups was similar 1 and 3 months after tube insertion (P>0.05), but was significantly lower in the experimental group at 6 months (P<0.05). Compared with control group, the experimental group showed significantly prolonged prothrombin time (P<0.05) but similar rest coagulation parameters. No serious drug-related side effects occurred in these two groups.

CONCLUSIONEarly use of urokinase is safe and effective for prevention and treatment of tunneled hemodialysis catheter-related fibrin sheaths with minimal side effects.

Peripherally inserted central catheter (PICC) has been widely used in the neonatal intensive care unit (NICU) in recent years, but there are potential risks for complications related to PICC. Based on the current evidence in China and overseas, the operation and management guidelines for PICC in neonates were developed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) in order to help the NICU staff to regulate the operation and management of PICC.
Catheterization, Central Venous/adverse effects* ; Catheterization, Peripheral/adverse effects* ; Catheters ; China ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal

While oral agents are currently suggested for the initial treatment of erectile dysfunction, penile prosthesis implantation (malleable or inflatable) is accepted as a third-line therapy if intracorporeal injection and intraurethral treatment fail as a secondary choice. Urethral erosion of the malleable penile prosthesis is a well-known complication, mostly due to the indwelling catheter. We report a case of urethral erosion of the malleable penile prosthesis after 23 years. The patient was a 45-year-old man without any underlying risk factors. He subsequently underwent a unilateral rod extraction under regional anaesthesia. It appears that urethral erosion of penile prostheses can appear at any time post operation, without any known facilitative factors and in any age group. Furthermore, simple office manoeuvres may not be possible in some patients.
Catheters, Indwelling ; adverse effects ; Erectile Dysfunction ; surgery ; Humans ; Male ; Middle Aged ; Penile Implantation ; adverse effects ; Penile Prosthesis ; adverse effects ; Prosthesis Failure ; Time Factors ; Treatment Outcome ; Urethra ; physiopathology ; surgery

Thoracic endovascular aortic repair (TEVAR) shows limitations in cases in which the aortic pathology involves the aortic arch. The study aims were to test a fenestrated aortic arch stent graft (FASG) with a preloaded catheter for the supraaortic arch vessels and to perform a preclinical study in swine to evaluate the safety and efficacy of this device. Six FASGs with 1 preloaded catheter and 5 FASGs with 2 preloaded catheters were advanced through the iliac artery in 11 swines. The presence of endoleaks and the patency and deformity of the grafts were examined with computed tomography (CT) at 4 weeks postoperatively. A postmortem examination was performed at 8 weeks. The mean procedure time for the one and two FASG groups was 30.2 (27.9-34.5) min and 43.1 (39.2-53.7) min. The mean time for the selection of the carotid artery was 4.8 (4.2-5.5) min and 6.2 (4.6-9.4) min. Major adverse event was observed in one of 11 pigs. One pig died at 4 weeks likely because of the effects of the high dose of ketamine, while the remaining 10 pigs survived 8-week. For both the one and two FASG groups, no endoleaks, no disconnection, no occlusion of the stent grafts were observed in the CT findings and the postmortem gross findings. The procedure with the FASG could be performed safely in a relatively short procedure time and involved an easy technique. The FASG is found to be safe and convenient in this preclinical study with swine.
Animals ; Aorta, Thoracic/*surgery ; Catheters ; Endovascular Procedures/adverse effects/*instrumentation ; *Stents ; Swine ; Tomography, X-Ray Computed

It is difficult to insert long-term dialysis catheters after severe stenosis or occlusion of the internal jugular vein and innominate vein. We used REcanalisation and balloon-oriented puncture for Re-insertion of dialysis catheter in nonpatent central veins (REBORN) in seven patients with severe central venous lesions, and all patients were inserted with long-term dialysis catheters successfully. None had severe complications such as pneumothorax, hemothorax, or pulmonary embolism during operation. All catheters functioned well after postoperative follow-up of 2 months. REBORN provides a novel approach to establish difficult dialysis pathways.
Humans ; Catheterization, Central Venous/adverse effects* ; Catheters, Indwelling ; Renal Dialysis ; Jugular Veins ; Punctures

The female infant in this case study was admitted to the hospital 4 hours after birth due to preterm birth and respiratory distress. On the third day after birth, peripherally inserted central venous catheter (PICC) catheterization was performed. On day 42, thrombus was found at the entrance of the right atrium from the inferior vena cava during a cardiac ultrasound, and it was considered to be related to PICC placement. Low-molecular-weight heparin and urokinase were given. After two weeks of treatment, ultrasonic monitoring showed thrombus shrinkage. No bleeding or pulmonary embolism occurred during the treatment. The patient discharged after improvement. This article mainly introduces a multidisciplinary team approach to diagnosis and treatment of PICC-related thrombosis in neonates.
Infant, Newborn ; Infant ; Humans ; Female ; Central Venous Catheters/adverse effects* ; Premature Birth ; Dyspnea ; Echocardiography ; Catheterization, Peripheral

To further demonstrate the toxicity of the catheter, cytotoxicity evaluation was conducted in registration inspection products and the relationship between testing methods and materials were analyzed. This result showed that to strengthen cytotoxicity assay in registration inspection is important to choose catheter in clinic.
Cells, Cultured ; Cytotoxins ; toxicity ; Disposable Equipment ; Humans ; Materials Testing ; Urinary Catheters ; adverse effects

Objective: To investigate the timing of pericardial drainage catheter removal and restart of the anticoagulation in patients with atrial fibrillation (AF) suffered from perioperative pericardial tamponade during atrial fibrillation catheter ablation and uninterrupted dabigatran. Methods: A total of 20 patients with pericardial tamponade, who underwent AF catheter ablation with uninterrupted dabigatran in Beijing Anzhen Hospital from January 2019 to August 2021, were included in this retrospective analysis. The clinical characteristics of enrolled patients, information of catheter ablation procedures, pericardial tamponade management, perioperative complications, the timing of pericardial drainage catheter removal and restart of anticoagulation were analyzed. Results: All patients underwent pericardiocentesis and pericardial effusion drainage was successful in all patients. The average drainage volume was (427.8±527.4) ml. Seven cases were treated with idarucizumab, of which 1 patient received surgical repair. The average timing of pericardial drainage catheter removal and restart of anticoagulation in 19 patients without surgical repair was (1.4±0.7) and (0.8±0.4) days, respectively. No new bleeding, embolism and death were reported during hospitalization and within 30 days following hospital discharge. Time of removal of pericardial drainage catheter, restart of anticoagulation and hospital stay were similar between patients treated with idarucizumab or not. Conclusion: It is safe and reasonable to remove pericardial drainage catheter and restart anticoagulation as soon as possible during catheter ablation of atrial fibrillation with uninterrupted dabigatran independent of the idarucizumab use or not in case of confirmed hemostasis.
Humans ; Atrial Fibrillation/drug therapy* ; Dabigatran/therapeutic use* ; Cardiac Tamponade/complications* ; Anticoagulants/therapeutic use* ; Retrospective Studies ; Treatment Outcome ; Drainage/adverse effects* ; Catheter Ablation ; Catheters/adverse effects*