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Hemodialysis catheter integrity during mechanical power injection of iodinated contrast medium for computed tomography angiography

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Abstract

Purpose

CT angiography (CTA) requires vascular access with flow rates of 5–7 mL/s. Hemodialysis (HD) is performed at 6–10 mL/s. The purpose of our study is to evaluate the structural integrity of HD catheters in the administration of contrast media via a mechanical power injector under varying conditions.

Methods

Four HD catheters were evaluated in an in vitro study. Tested were contrast media type (iopamidol 300 and 370 mgI/mL), temperature (25 and 37 °C), catheter diameter (14 Fr to 16 Fr all with double-lumen capacity), catheter length (19–32 cm), and simultaneous double-lumen or single-lumen injection within each of the catheters. Peak plateau pressures (psi) were recorded with flow rates from 5 to 20 mL/s in 5 mL/s increments. In total, 864 unique injections were performed.

Results

No catheter failure (bulging/rupture) was observed in 864 injections. Maximum pressure for single-lumen injection was 51.7 psi (double-lumen: 26.3 psi). Peak pressures were significantly lower in simultaneous double-lumen vs. single-lumen injections (p < 0.001) and low vs. high viscosity contrast media (p < 0.001). Neither larger vs. smaller diameter lumens (p = 0.221) nor single-lumen injection in arterial vs. venous (p = 0.834) were significantly different.

Conclusion

HD catheters can be used to safely administer iodinated contrast media via mechanical power injection in in vitro operating conditions. Maximum peak pressure is below the manufacturer’s 30 psi limit at flow rates up to 20 mL/s in double-lumen injections and up to 10 mL/s in single-lumen injections, which is higher than the usual maximum of 8 mL/s for CT angiography in clinical settings.

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Data availability

The data were available to all authors in full.

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Acknowledgements

The catheters were donated to our department by the vendors, but the vendors had no access to or control over the experiments or the data.

Funding

Funding was provided by the Departments of Radiology and Engineering at Duke University.

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Authors and Affiliations

  1. Department of Radiology, Duke University, 2301 Erwin Road, Box 3830, Durham, NC, 27710, USA

    Fides R. Schwartz, Douglas S. Lewis, Laurens E. Howle, Charles Y. Kim & Rendon C. Nelson

  2. Department of Mechanical Engineering and Materials Science, Duke University, 239 Hudson Engineering Bldg, Box 90300, Durham, NC, 27708-0300, USA

    Amy E. King & Laurens E. Howle

  3. US Navy Experimental Diving Unit, 321 Bullfinch Rd, Panama City Beach, FL, 32407, USA

    F. Gregory Murphy IV

  4. Department of Marine Science and Conservation, Duke University, 9 Circuit Drive, Durham, NC, 27710, USA

    Laurens E. Howle

  5. BelleQuant Engineering, PLLC, 7813 Dairy Ridge Rd, Mebane, NC, 27302-9281, USA

    Laurens E. Howle

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  1. Fides R. Schwartz
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Correspondence to Fides R. Schwartz.

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Schwartz, F.R., Lewis, D.S., King, A.E. et al. Hemodialysis catheter integrity during mechanical power injection of iodinated contrast medium for computed tomography angiography. Abdom Radiol 46, 2961–2967 (2021). https://doi.org/10.1007/s00261-020-02905-9

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  • DOI: https://doi.org/10.1007/s00261-020-02905-9

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