Przydatność elektronowej mikroskopii skaningowej w ocenie stopnia zużycia cewników naczyniowych – doniesienie wstępne

Waldemar Machała¹, Leszek Klimek², Wojciech Gaszyński³

Summary
Cannulation of blood vessels is common practice in modern medicine. Devices designed for long term cannulation should meet the highest possible standards to avoid complications. Vascular cannulation has been associated with a number of device-specific complications that can manifest during insertion, while indwelling, or after removal. Electron microscopic photographs were taken of 14 arterial and 21 venous cannulas, that had been inserted by Seldinger technique and removed after completion of the treatment, comparing them with similar but unused devices. Methods. All arterial and venous catheters were photographed under scanning electron microscopy after dusting them with gold powder. Scans were made with 40 -1000X magnification. Results. The electron microscopic pictures revealed erosion damage on the surface of used venous and arterial catheters, up to 15 mm deep. Such lesions are typical for high flow system tubing. Even the surfaces of brand new devices were not completely smooth. Discussion and conclusions. The electron microscopic pictures clearly indicated that the surface of long-term catheters is porous and eroded, therefore substantially increasing the risk of thrombi formation. The degree of damage probably depends on duration and purpose of cannulation, coagulation status, blood cells interacting with the surface of the cannula etc. The deterioration of the surface of indwelling vascular catheters requires further study.

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