SCANNING ELECTRON-MICROSCOPIC INVESTIGATI ONS OF LARGE-HERE CATHETERSWITH SILVER OR SILICONE COATED SURFACES FOR THROMBOSIS AND INFECTION REDUCTION

Since the introduction of large-bore catheters for acute hemodialysis 30 years ago, many problems with handling, material, and contamination of these catheters exist. Nevertheless, catheterization of the inferi or and superior vena cava with a large-bore catheter has proved to be suitable as a rapid connection process for extracorporeal detoxificati on methods. Large bore catheters with surface modification were evalua ted after 1 to 289 days in situ for thrombus build-up (using scanning electron microscopy) and for bacterial colonization. In a retrospectiv e study in 58 patients, 67 surface catheters (Spi-Silicone: n = 28, Sp i-Argent I: n = 22, Spi-Argent II: n = 17) were inserted in the intern al jugular and subclavian veins and investigated after removal. Bacter ial colonization was observed in 8.9% in contrast to 38.1% in untreate d catheters. The scanning electron microscope investigations showed in all catheters a very low thrombogenecity. The ion beam-based processe s make the surface-treated catheters thrombus and infection resistant.