Thrombogenicity of angiographic catheters.

Abstract

A radioimmunoassay for measurement of canine fibrinopeptide A, which provides a quantitative index of thrombin action on fibrinogen, was applied to measurement of the thrombogenicity of 5 angiographic catheters commercially available and presently in clinical use. Examples of thin-walled polyethylene, wired polyethylene, Teflon, polyurethane and woven Dacron catheters were characterized in terms of chemical composition, surface physiochemical properties and their procoagulant activities assessed in vivo in an experimental system that closely simulated their actual clinical use. The catheters could be divided into 3 groups based on the fibrinopeptide A levels generated during a 30 min test period and on the surface deposition of fibrin and platelets, as judged by scanning electron microscopy. Group I (thin-walled polyethylene) showed no increase in fibrinopeptide A levels over control and no fibrin deposition, but moderate platelet deposition. Group II (wired polyethylene and Teflon) showed moderate increases in fibrinopeptide A levels, with moderate fibrin and platelet deposition. Group III catheters (polyurethane and woven Dacron) showed marked fibrinopeptide A production and extensive fibrin deposition that contained variable numbers of platelet aggregates. Fibrinopeptide A levels correlate well with surface fibrin deposition and are useful to assess the degree of which different catheters stimulate fibrin production. It may be that the procoagulant effects of these catheters are mediated through the textural and physiochemical properties of the surfaces of these devices, which are in contact with blood.