Slide 1: -:By Group C
Bibin .C, Idrees .H, Shruti .I. 1 CATHETERS Slide 2: 2 What is a
CATHETER ? Slide 3: 3 Late Latin, from Greek:
KATHETER, came from KATHIENAI,
kathe- to send down : kat-, kata-, cata- + hienai- to send . HISTORY AND ORIGIN OF “CATHETER” Slide 4: 4 DEFINITION: A catheter is a hollow flexible tube that can be inserted into a body cavity, duct or vessel. Catheters thereby allow drainage or injection of fluids , distend a passageway or provide access by surgical instruments.
The process of inserting a catheter is catheterization. In most uses a catheter is a thin,
flexible tube: a "soft" catheter;
in some uses,
it is a larger, solid tube: a "hard" catheter. Slide 5: 5 What is a Catheter made up of ? Materials:
A range of polymers are used for the construction of catheters, including silicone rubber latex and
Silicone is one of the most common choices because it is inert and unreactive to body fluids and a range of medical fluids with which it might come into contact. Materials:
Fluoropolomers (PTFE) (TEFLON)
Silicone (SI) Slide 6: 6 Ideal characteristics of catheters Better Torque Control
Low Surface frictional resistance for good trackability
over guide wire. Slide 7: 7 PARTS OF A CATHETER HUB
TIP HUB BODY TIP Slide 8: 8 FRENCH CATHETER SCALE:
The French catheter scale (most correctly abbreviated as Fr, but also often abbreviated as FR or F) is commonly used to measure the outer diameter of cylindrical medical instruments including catheters ,needles etc.
In the French Gauge system as it is also known, the diameter in millimeters of the catheter can be determined by dividing the French size by 3, thus an increasing French size corresponds with a larger diameter catheter. The following equations summarize the relationships:
D(mm) = Fr/3 or Fr = D(mm)*3 MEASUREMENT: Most commonly in adult Diagnostic Catheters of 5 – 7 Fr is used. Slide 9: 9 Slide 10: 10 TYPES OF CATHETERS: CLASSIFICATION :
Catheters can be classified depending on
SIDE HOLES :
-: Single Hole
-:End Hole with side holes.
-:Blocked end with side holes only.
Abdominal – 6-80 cm
Thoracic or Carotid Arteries – 100-120 cm
NOTE: Size depends on :
> age of the patient
> selective or super selective study
> size of the vessels.
NOTE: Ideal practice is to use the smallest diameter catheter feasible for any particular study to minimize the risk of arterial damage by the procedure. Slide 11: 11 TYPES OF CATHETERS SHAPES
Cobra Shaped Catheter
Side Winder Catheters (Shepherd) Slide 12: 12 Some Other Types of Catheters:
Hydrophilic Catheters :
Hydrophilic-coated catheters have a layer of polymer coating that is bound to the catheter surface.
The polymer absorbs and binds water to the catheter, resulting in a thick, smooth and slippery surface.
Intermittent catheters are hollow tubes used to drain
urine from the bladder.
Usually its around 80cm. Slide 13: Different Catheter Curves For Different Purposes:
> Judkins Left (JL)
> Judkins Right ( JR)
> Judkins Left Short Tip
> Judkins Right Short Tip
> Amplatz Left ( AL)
> Amplatz Right ( AR)
> Left Coronary Bypass
> Right Coronary Bypass
> Cardiac Pigtail
> Multipurpose Slide 14: 14 Judkins Left Judkins Right Amplatz Left Amplatz Right Slide 15: 15 CATHETERS CAN BE BROADLY CLASSIFIED
UNDER THESE GROUPS: DIAGNOSTIC CATHETERS
Used for Angiographs .
Used for Angioplasty. Guiding catheters are like angiography catheters only difference is that guiding catheters are more stiffer & firm as it carries Balloon catheters, PTCA wires and stent delivery system.
Mild stiffness comes due to the wire braided design.
Good Push ability .
Good Tractability. Slide 16: 16 Balloon Catheters: Slide 17: 17 Butterfly Catheters Foleys Catheter (1way, 2way or 3way) Slide 18: 18 PUNCTURE NEEDLES: Used to cannulate or puncture the artery.
Usual Sizes include
18 ga, 19 ga , 20ga, 21 ga.
The selection of the Size depends on
the guide wire going to be inserted
through that needle port. Seldinger Needle Slide 19: 19 GUIDE WIRE: Diagnostic guide wires are used to traverse vascular anatomy to aid in placing catheters and other devices. Guide wires are used for both Cardiology and Radiology angiographic procedures. Guide wires are relatively simple spring type wires that
provides necessary firmness and the control to the site where
Angiogram will be taken.
A the name suggests it ‘ Guides’ the catheter.
PTFE coated Soft tip for the smoothness during the insertion
Less trauma to the intimal wall of the artery Slide 20: 20 Shape of the Tip :
J Tip / Straight Tip Slide 21: 21 In 1929 Werner Forssmann
demonstrated that a simple
Rubber catheter could be passed to
the pulmonary artery through the
Anti- Cubital Vein and
An angiographic film could be
obtained using radiographic
contrast. Slide 22: 22 Sven- Ivar Seldinger In 1953 ,
Sven –Ivar Seldinger invented
The technique of gaining access
Percutaneusly into an artery
without An arteriotomy. Slide 23: 23 TECHNIQUE OF INSERTING A CATHETER SELDINGER TECHNIQUE: The technique of catheter insertion via
double-wall needle puncture and guide-wire is known as
The SELDINGER TECHNIQUE. Double Wall Puncture:
Compression to prevent Hematoma of the other wall.
Rotatory movement to get the needle into the lumen.
Single Wall Puncture:
Usually done for patients co-agulation time is less. Slide 24: 24 Slide 25: 25 Slide 26: 26 Slide 27: 27 COMPLETE APPARATUS: > Needle
Catheter Slide 28: 28 USES & APPLICATION s OF CATHETERS: Placement of a catheter into a particular part of the body may allow:
Draining urine from the urinary bladder as in urinary catheterization, e.g., the Foley catheter.
Drainage of urine from the kidney pelvis by percutaneous nephrostomy.
Drainage of fluid collections, e.g. an abdominal abscess.
Administration of intravenous fluids, medication or parenteral nutrition with a peripheral venous catheter.
Angioplasty , angiography , balloon septostomy, balloon angioplasty. Often Seldinger technique is used. Slide 29: 29 Direct measurement of blood pressure in an artery or vein.
Direct measurement of intracranial pressure.
Administration of anesthetic medication into the epidural space, the subarachnoid space, or around a major nerve bundle such as the brachial plexus.
Subcutaneous administration of insulin or other medications.
A central venous catheter is a conduit for giving drugs or fluids into a large-bore catheter positioned either in a vein near the heart or just inside the atrium.
A Swan - Ganz catheter is a special type of catheter placed into the pulmonary artery for measuring pressures in the heart. CONTD… Slide 30: 30 Slide 31: 31 Slide 32: 32 Slide 33: 33 Method s and apparatus for cleaning, decontaminating, and sterilizing catheters
Before giving for sterilization, catheter should be washed in water and with air jets so that clots in the catheter lumen come out.
Methods for cleaning, decontaminating, and sterilizing catheters are by using a combination of liquid and gaseous/plasma sterilization techniques to ensure the complete and efficient sterilization of a catheter .
Angiographic dye and saline are removed from the interior of the balloon and its lumen .
The outer surfaces of the catheter and a guide wire lumen of the catheter are cleaned, decontaminated, and sterilized with a liquid sterilant.
The liquid sterilant fills a balloon and a balloon lumen of the catheter .
The filling, retaining, and draining steps are repeated until an interior of the balloon and the balloon lumen are sterilized. Slide 34: 34 STERLIZATION OF CATHETERS: Methods for catheter sterilization :
The catheter is dried and then a plasma or gaseous sterilant is used to sterilize at least the outer surfaces and the guide wire lumen of the catheter.
Techniques for effectively sterilizing catheters, particularly long-dwelling intravenous catheters includes
>> the transmission and dispersion of ultraviolet or infrared radiation Slide 35: 35 REFERENCES:
Radiological Procedures –A Guideline
Cardiac Catheterization. Slide 36: 36