View source for Catheter

{{Short description|Medical tubes inserted in the body to extract or administer substances}}
{{Use American English|date = January 2019}}
{{Use mdy dates|date = January 2019}}
{{infobox medical equipment
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| caption      = Catheter disassembled
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In [[medicine]], a '''catheter''' ({{IPAc-en|ˈ|k|æ|θ|ə|t|ə|r|}}<ref>{{cite web|url=https://www.oxfordlearnersdictionaries.com/definition/english/catheter |title=catheter noun - Definition, pictures, pronunciation and usage notes &#124; Oxford Advanced Learner's Dictionary at |publisher=Oxfordlearnersdictionaries.com |date= |access-date=2022-05-06}}</ref> {{Respell|KA|thə|tər}}) is a thin [[tubing (material)|tube]] made from [[medical grade]] materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Catheters are manufactured for specific applications, such as cardiovascular, urological, gastrointestinal, neurovascular and ophthalmic procedures. The process of inserting a catheter is called ''catheterization''.

In most uses, a catheter is a thin, flexible tube (''soft'' catheter) though catheters are available in varying levels of stiffness depending on the application. A catheter left inside the body, either temporarily or permanently, may be referred to as an "indwelling catheter" (for example, a [[peripherally inserted central catheter]]). A permanently inserted catheter may be referred to as a "permcath" (originally a trademark).

Catheters can be inserted into a body cavity, duct, or vessel, brain, skin or adipose tissue. Functionally, they allow drainage, administration of fluids or gases, access by surgical instruments, and also perform a wide variety of other tasks depending on the type of catheter.<ref>{{cite book |last=Diggery |first=Robert |title=Catheters: Types, applications and potential complications (medical devices and equipment |year=2012 |publisher=Nova Science |isbn=978-1-62100-630-5}}</ref> Special types of catheters, also called probes, are used in preclinical or clinical research for sampling of lipophilic and hydrophilic compounds,<ref>{{Cite journal|last1=Altendorfer-Kroath|first1=Thomas|last2=Schimek|first2=Denise|last3=Eberl|first3=Anita|last4=Rauter|first4=Günther|last5=Ratzer|first5=Maria|last6=Raml|first6=Reingard|last7=Sinner|first7=Frank|last8=Birngruber|first8=Thomas|date=January 2019|title=Comparison of cerebral Open Flow Microperfusion and Microdialysis when sampling small lipophilic and small hydrophilic substances|journal=Journal of Neuroscience Methods|volume=311|pages=394–401|doi=10.1016/j.jneumeth.2018.09.024|pmid=30266621|s2cid=52883354|issn=0165-0270}}</ref> protein-bound and unbound drugs,<ref>{{Cite journal|last1=Schaupp|first1=L.|last2=Ellmerer|first2=M.|last3=Brunner|first3=G. A.|last4=Wutte|first4=A.|last5=Sendlhofer|first5=G.|last6=Trajanoski|first6=Z.|last7=Skrabal|first7=F.|last8=Pieber|first8=T. R.|last9=Wach|first9=P.|author-link8= Thomas Pieber|date=1999-02-01|title=Direct access to interstitial fluid in adipose tissue in humans by use of open-flow microperfusion|journal=American Journal of Physiology. Endocrinology and Metabolism|volume=276|issue=2|pages=E401–E408|doi=10.1152/ajpendo.1999.276.2.e401|pmid=9950802|issn=0193-1849}}</ref><ref>{{Cite journal|last1=Ellmerer|first1=Martin|last2=Schaupp|first2=Lukas|last3=Brunner|first3=Gernot A.|last4=Sendlhofer|first4=Gerald|last5=Wutte|first5=Andrea|last6=Wach|first6=Paul|last7=Pieber|first7=Thomas R.|date=2000-02-01|title=Measurement of interstitial albumin in human skeletal muscle and adipose tissue by open-flow microperfusion|journal=American Journal of Physiology. Endocrinology and Metabolism|volume=278|issue=2|pages=E352–E356|doi=10.1152/ajpendo.2000.278.2.e352|pmid=10662720|s2cid=11616153 |issn=0193-1849}}</ref> neurotransmitters, peptides and proteins, antibodies,<ref>{{Cite journal|last1=Dragatin|first1=Christian|last2=Polus|first2=Florine|last3=Bodenlenz|first3=Manfred|last4=Calonder|first4=Claudio|last5=Aigner|first5=Birgit|last6=Tiffner|first6=Katrin Irene|last7=Mader|first7=Julia Katharina|last8=Ratzer|first8=Maria|last9=Woessner|first9=Ralph|last10=Pieber|first10=Thomas Rudolf|last11=Cheng|first11=Yi|date=2015-11-23|title=Secukinumab distributes into dermal interstitial fluid of psoriasis patients as demonstrated by open flow microperfusion|journal=Experimental Dermatology|volume=25|issue=2|pages=157–159|doi=10.1111/exd.12863|pmid=26439798|s2cid=34556907|issn=0906-6705|doi-access=free}}</ref><ref>{{Cite journal|last1=Kolbinger|first1=Frank|last2=Loesche|first2=Christian|last3=Valentin|first3=Marie-Anne|last4=Jiang|first4=Xiaoyu|last5=Cheng|first5=Yi|last6=Jarvis|first6=Philip|last7=Peters|first7=Thomas|last8=Calonder|first8=Claudio|last9=Bruin|first9=Gerard|last10=Polus|first10=Florine|last11=Aigner|first11=Birgit|date=March 2017|title=β-Defensin 2 is a responsive biomarker of IL-17A–driven skin pathology in patients with psoriasis|journal=Journal of Allergy and Clinical Immunology|volume=139|issue=3|pages=923–932.e8|doi=10.1016/j.jaci.2016.06.038|pmid=27502297|s2cid=30272491|issn=0091-6749|doi-access=free}}</ref><ref>{{Cite journal|last1=Kleinert|first1=Maximilian|last2=Kotzbeck|first2=Petra|last3=Altendorfer-Kroath|first3=Thomas|last4=Birngruber|first4=Thomas|last5=Tschöp|first5=Matthias H.|last6=Clemmensen|first6=Christoffer|date=December 2019|title=Corrigendum to "Time-resolved hypothalamic open flow micro-perfusion reveals normal leptin transport across the blood–brain barrier in leptin resistant mice" [Molecular Metabolism 13 (2018) 77–82]|journal=Molecular Metabolism|volume=30|page=265|doi=10.1016/j.molmet.2019.11.001|pmid=31767178|pmc=6889745|issn=2212-8778}}</ref> [[nanoparticle]]s and nanocarriers, enzymes and vesicles.

==Etymology==
"Catheter" (from [[Ancient Greek|Greek]] {{lang|grc|καθετήρ}} ''kathetḗr'') comes from the Greek verb {{lang|grc|καθίεμαι}} ''kathíemai'', meaning "to thrust into" or "to send down" because the catheter allowed fluid to be "sent down" from the body.<ref>{{Cite journal|title=Urinary catheters: history, current status, adverse events and research agenda|first1=Roger C. L.|last1=Feneley|first2=Ian B.|last2=Hopley|first3=Peter N. T.|last3=Wells|date=November 17, 2015|journal=Journal of Medical Engineering & Technology|volume=39|issue=8|pages=459–470|doi=10.3109/03091902.2015.1085600|pmid=26383168|pmc=4673556}}</ref>

==Uses==

[[File:In line suction catheter placement in ventilator circuit.png|thumb|In-line suction catheter used in ventilator circuit for delivering air into lungs]]
[[Image:Urinary catheter.JPG|thumb|Single-use urinary catheter, 40 cm]]
Placement of a catheter into a particular part of the body may allow:
* Draining [[urine]] from the [[urinary bladder]] as in [[urinary catheterization]], using [[intermittent catheter]]s or [[Foley catheter]] inserted through [[urethra]]. When the urethra is damaged, [[Suprapubic cystostomy|suprapubic catheterisation]] is used instead. The suprapubic catheter is inserted through the lower part of the abdomen directly into the urinary bladder.<ref>{{cite web |url=https://medlineplus.gov/ency/article/003981.htm |title=MedlinePlus: Urinary catheters |date=6 November 2019 |publisher=U.S. National Library of Medicine }}</ref>
* drainage of urine from the kidney by percutaneous (through the skin) [[nephrostomy]]
* drainage of fluid collections, e.g. an abdominal [[abscess]]
* pigtail catheter: used to drain air from around the lung ([[pneumothorax]])
* administration of [[intravenous]] fluids, [[medication]] or [[parenteral nutrition]] with a [[peripheral venous catheter]] or [[central venous catheter]]
* [[angioplasty]], [[angiography]], [[balloon septostomy]], [[sinuplasty (procedure)|balloon sinuplasty]], [[cardiac electrophysiology|cardiac electrophysiology testing]], [[catheter ablation]]. Often the [[Seldinger technique]] is used.
* direct measurement of [[blood pressure]] in an [[artery]] or [[vein]]
* direct measurement of [[intracranial pressure]]
* administration of [[anaesthetic]] medication into the [[epidural]] space, the [[subarachnoid space]], or around a major nerve bundle such as the [[brachial plexus]]
* transfer of fertilized embryos, from [[in vitro fertilization]], or sperm, during [[artificial insemination]], into the uterus
* administration of [[oxygen]], [[Volatile anaesthetic|volatile anesthetic agents]], and other breathing gases into the lungs using a [[tracheal tube]]
* [[Subcutis|subcutaneous]] administration of [[insulin]] or other medications, with the use of an [[infusion set]] and [[insulin pump]]

==History==
===Ancient inventors===
[[File:Roman catheters.jpg|thumb|Catheters from the [[Roman Empire]], 1st century AD]]
Ancient Chinese used onion stalks, the Romans, Hindus, and Greeks used tubes of [[wood]] or [[precious metals]].<ref>{{cite web |url=https://www.mdtmag.com/blog/2015/06/medtech-memoirs-catheters |title=MedTech Memoirs: Catheters |date=16 June 2015 |publisher=Advantage Business Media |url-status=live |archive-url=https://web.archive.org/web/20171024160847/https://www.mdtmag.com/blog/2015/06/medtech-memoirs-catheters |archive-date=24 October 2017 }}</ref>

The ancient Egyptians created catheters from [[Reed (plant)|reed]]s.

===Modern===
The earliest invention of the flexible catheter was during the 18th century.<ref>{{cite web |url=http://www.urologichistory.museum/content/milestones/catheterization/p1.cfm |title=Didusch Site - Milestones - Relief in a Tube: Catheters Remain a Steadfast Treatment for Urinary Disorders |website=www.urologichistory.museum |url-status=live |archive-url=https://web.archive.org/web/20150117042240/http://www.urologichistory.museum/content/milestones/catheterization/p1.cfm |archive-date=2015-01-17 }}</ref> Extending his inventiveness to his family's medical problems, [[Benjamin Franklin]] invented the flexible catheter in 1752 when his brother John suffered from bladder stones. Franklin's catheter was made of metal with segments hinged together with a wire enclosed to provide rigidity during insertion.<ref name="Minnesota Historical Society">{{cite web |title=Benjamin Franklin: In Search of a Better World |publisher=Minnesota Historical Society |url=http://benfranklinexhibit.org/resume |archive-url=https://web.archive.org/web/20110812083821/http://benfranklinexhibit.org/resume |archive-date=12 August 2011 }}</ref><ref>{{cite journal |author=Hirschmann, J.V. |date=December 2005 |title=Benjamin Franklin and Medicine |journal=Annals of Internal Medicine |volume=143 |issue=11 |pages=830–4 |doi=10.7326/0003-4819-143-11-200512060-00012 |pmid=16330795 |s2cid=32882591 |url=http://annals.org/data/Journals/AIM/20104/0000605-200512060-00012.pdf |access-date=January 2, 2013 |archive-url=https://web.archive.org/web/20191217033117/https://annals.org/aim/article-abstract/718880/benjamin-franklin-medicine |archive-date=December 17, 2019 }}</ref>

According to a footnote in his letter in Volume 4 of the Papers of Benjamin Franklin (1959), Franklin credits Francesco Roncelli-Pardino from 1720 as the inventor of a flexible catheter. In fact, Franklin claims the flexible catheter may have been designed even earlier.<ref>{{cite journal |author=Huth, E.J. |title=Benjamin Franklin's place in the history of medicine |journal=Journal of the Royal College of Physicians of Edinburgh |volume=37 |issue=4 |year=2007 |pages=373–8 |doi=10.1177/1478271520073704013 |pmid=18447203 |url=http://www.rcpe.ac.uk/journal/issue/journal_37_4/Huth.pdf}}</ref>

An early modern application of the catheter was employed by [[Claude Bernard]] for the purpose of cardiac catheterization in 1844. The procedure involved entering a horse's ventricles via the jugular vein and carotid artery.<ref>{{cite book |author-link1=Donald S. Baim |last=Baim |first=Donald |title=Grossman's Cardiac Catheterization, Angiography, and Intervention |year=2005 |publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-5567-2}}</ref>

In 1929, [[Werner Forssmann|Werner Forssman]] first performed [[Central venous catheter|central venous catheterization]],<ref name=":0">{{Cite journal |last1=Smith |first1=Reston N. |last2=Nolan |first2=Jerry P. |date=2013-11-11 |title=Central venous catheters |url=https://www.bmj.com/content/347/bmj.f6570 |journal=BMJ |language=en |volume=347 |article-number=f6570 |doi=10.1136/bmj.f6570 |issn=1756-1833 |pmid=24217269|s2cid=16939469 |url-access=subscription }}</ref> work which led to the development of [[Cardiac catheterization|cardiac catherization]] as a treatment, for which he, [[André Frédéric Cournand|André F. Cournand]] and [[Dickinson W. Richards]] would win the [[Nobel Prize in Physiology or Medicine|Nobel Prize for Medicine]] in 1959.<ref>{{Cite web |title=The Nobel Prize in Physiology or Medicine 1956 |url=https://www.nobelprize.org/prizes/medicine/1956/forssmann/biographical/ |access-date=2023-07-16 |website=NobelPrize.org |language=en-US}}</ref> Central venous catheterization allows for continuous administration of medications, fluids and blood products to a large vein, particularly in critically ill patients.<ref name=":0" /> Cardiac catheterization is the insertion of a catheter into one of the chambers of the heart, which is used for imaging, diagnosis, and the placement of devices such as stents.<ref>{{Citation |last1=Manda |first1=Yugandhar R. |title=Cardiac Catheterization Risks and Complications |date=2023 |url=https://www.ncbi.nlm.nih.gov/books/NBK531461/ |work=StatPearls |access-date=2023-07-16 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30285356 |last2=Baradhi |first2=Krishna M.}}</ref>

[[David S. Sheridan]] invented the modern disposable catheter in the 1940s.<ref name=WaPo>{{Cite news|url=https://www.washingtonpost.com/archive/local/2004/05/07/david-s-sheridan-catheter-p/4c6fb678-2d14-43f3-be53-734f2ae0a191/|title=David S. Sheridan|date=2004-05-07|newspaper=Washington Post}}</ref>  Prior to this, some reusable catheters consisted of braided cotton tubes, which were varnished, heat-treated and polished. As these were primarily produced in France, the advent of [[World War II]] threatened the supply chain.<ref>{{cite web|url=https://www.latimes.com/archives/la-xpm-2004-may-04-me-sheridan4-story.html|title=David Sheridan, 95; Dropout Invented Key Medical Device|date=May 4, 2004|website=Los Angeles Times}}</ref> Sheridan was dubbed the "Catheter King" by ''[[Forbes (magazine)|Forbes]]'' magazine in 1988. He also invented the modern "disposable" plastic [[endotracheal tube]] now used routinely in surgery.<ref name="WaPo" />

Other reusable catheters consisted of red rubber tubes. Although sterilized prior to reuse, they still posed a high risk of infection and often led to the spread of disease.<ref>{{Cite book |last=Engineers |first=NPCS Board of Consultants & |url=https://books.google.com/books?id=XwWJAgAAQBAJ&q=david+S.+Sheridan+Forbes+Magazine&pg=PA142 |title=Handbook on Medical and Surgical Disposable Products |date=January 1, 2014 |publisher=Niir Project Consultancy Services |isbn=978-93-81039-28-1 |via=Google Books}}</ref>{{rp|142}} 

To prevent [[clotting]], catheters that are not in use may be filled with [[catheter lock solution]].<ref>{{Cite journal |last1=Vanholder |first1=R. |last2=Canaud |first2=B. |last3=Fluck |first3=R. |last4=Jadoul |first4=M. |last5=Labriola |first5=L. |last6=Marti-Monros |first6=A. |last7=Tordoir |first7=J. |last8=Van Biesen |first8=W. |year=2010 |title=Diagnosis, prevention and treatment of haemodialysis catheter-related bloodstream infections (CRBSI): a position statement of European Renal Best Practice (ERBP) |journal=NDT Plus |volume=3 |issue=3 |pages=234–246 |doi=10.1093/ndtplus/sfq041 |pmc=6371390 |pmid=30792802}}</ref>

==Materials==
===Urinary catheters===
A range of [[polymer]]s are used for the construction of catheters, including [[silicone rubber]], [[nylon]], [[polyurethane]], polyethylene terephthalate (PET), [[latex]], and [[thermoplastic elastomer]]s. Silicone is one of the most common implantable choices because it is inert and unreactive to body fluids and a range of medical fluids with which it might come into contact. On the other hand, the polymer is weak mechanically, and a number of serious fractures have occurred in catheters.<ref>{{Cite journal |last1=McKenzie |first1=J. M. |last2=Flahiff |first2=C. M. |last3=Nelson |first3=C. L. |date=1 October 1993 |title=Retention and strength of silicone-rubber catheters. A report of five cases of retention and analysis of catheter strength. |url=http://jbjs.org/content/75/10/1505 |journal=J Bone Joint Surg Am |language=en |volume=75 |issue=10 |pages=1505–1507 |doi=10.2106/00004623-199310000-00011 |issn=0021-9355 |pmid=8408139 |archive-url=https://web.archive.org/web/20160923221049/http://jbjs.org/content/75/10/1505 |archive-date=September 23, 2016 |access-date=May 12, 2016 |url-access=subscription }}</ref><ref>{{Cite journal |last1=Agarwal |first1=Shaleen |last2=Gandhi |first2=Mamatha |last3=Kashyap |first3=Randeep |last4=Liebman |first4=Scott |date=1 March 2011 |title=Spontaneous Rupture of a Silicone Peritoneal Dialysis Catheter Presenting Outflow Failure and Peritonitis |url=https://journals.sagepub.com/doi/abs/10.3747/pdi.2010.00123 |journal=Peritoneal Dialysis International |language=en |volume=31 |issue=2 |pages=204–206 |doi=10.3747/pdi.2010.00123 |doi-broken-date=July 11, 2025 |issn=0896-8608 |pmid=21427251 |url-status=live |archive-url=https://web.archive.org/web/20180508150819/http://www.pdiconnect.com/content/31/2/204 |archive-date=8 May 2018 }}</ref><ref>{{Cite journal |last1=Mirza |first1=Bilal |last2=Saleem |first2=Muhammad |last3=Sheikh |first3=Afzal |date=14 August 2010 |title=Broken Piece of Silicone Suction Catheter in Upper Alimentary Tract of a Neonate |journal=APSP Journal of Case Reports |volume=1 |issue=1 |page=8 |issn=2218-8185 |pmc=3417984 |pmid=22953251}}</ref> For example, silicone is used in [[Foley catheter]]s where fractures have been reported, often requiring surgery to remove the tip left in the bladder.

===Catheters used in interventional procedures===
Depending on the mechanical characteristics required, assorted polymers and polymer-metal composites can be used to build catheters used for interventional purposes. Common materials include polyamide (nylon), polyether block amide, polyuerathane, polyethylene terephthalate, and [[polyimide]]s. These materials are often used in combination with each other and are frequently layered on top of stainless steel braiding, laser-cut stainless steel tubing, or other scaffold-like structures to impart desirable handling characteristics to the catheter, all dependent on the intended application. For example, the materials and the architectures used to manufacture vascular catheters for neurological applications might differ significantly from catheters destined for cardiovascular use. 

Guiding catheters (catheters that guides angioplasty balloons and stents) is made up of [[polytetrafluoroethylene]] (PTFE) innermost layer which is lubricious, followed by [[stainless steel]] braid wire outer layer which helps to provide support for the catheter and prevent kinking while travelling through blood vessels, and [[Nylon]] elastomer outermost layer which provides extra support for the catheter and preserve the curvature of the catheter while passing through tortuous vessels.<ref name="Ali 2012">{{Cite journal |last1=Ali |first1=Ronan |last2=Greenbaum |first2=Adam B. |last3=Kugelmass |first3=Aaron D. |date=2012 |title=A Review of Available Angioplasty Guiding Catheters, Wires and Balloons – Making the Right Choice |url=https://www.icrjournal.com/articleindex/icr.2012.7.2.100 |journal=Interventional Cardiology Review |language=en |volume=7 |issue=2 |page=100 |doi=10.15420/icr.2012.7.2.100 |issn=1756-1477|url-access=subscription }}</ref>

To enhance ease of insertion, some catheters have a lubricious surface coating to lessen friction. A lubricious coating creates a smooth, slippery film making the catheter easier to insert.

==Interventional procedures==
[[File:Pigtail catheter settings.jpg|thumb|300px|Various settings of a 6 [[French catheter scale|French]] pigtail catheter with locking string, obturator (also called ''stiffening cannula'') and puncture needle.<br />'''A'''. Overview.<br />'''B'''. Both puncture needle and obturator engaged, allowing for direct insertion.<br />'''C'''. Puncture needle retracted. Obturator engaged. Used for example in steady advancement of the catheter on a guidewire.<br />'''D'''. Both obturator and puncture needle retracted, when the catheter is in place.<br />'''E'''. Locking string is pulled (bottom center) and then wrapped and attached to the superficial end of the catheter.]]

===Diagnostic catheters===
There are various catheters used in [[angiography]] procedures. Diagnostic catheters<ref name="Ali 2012"/><ref name="Themes 2016">{{cite web|last=Themes|first=U. F. O.|date=2016-06-20|title=Catheter-Based Technology and Devices|url=https://thoracickey.com/catheter-based-technology-and-devices/|access-date=2021-08-15|website=Thoracic Key|language=en-US}}</ref> direct wires through blood vessels. [[Radiocontrast agent]] is then injected through the catheter to visualise the vessels via various imaging methods such as [[computed tomography]] (CT), [[projectional radiography]], and [[fluoroscopy]].<ref name="Themes 2016"/> Pigtail catheter is a non-selective catheter with multiple side holes that can deliver large volumes of contrast into a blood vessel for imaging purposes.<ref name="Davies 2005"/> Cobra catheter is a selective catheter used to catheterise downgoing vessels in the abdomen. Cobra catheters move forward by pushing and are removed by pulling.<ref>{{cite web |last1=Bakal |first1=CW |last2=Flacke |first2=S |title=Diagnostic Catheters and Guidewires |date=December 23, 2015 |url=https://radiologykey.com/diagnostic-catheters-and-guidewires/ |publisher=Radiology Key |access-date=3 February 2022 |archive-url=https://archive.today/20220203112342/https://radiologykey.com/diagnostic-catheters-and-guidewires/ |archive-date=3 February 2022}}</ref> Sidewinder catheter is a selective catheter is used to navigate the aorta.<ref name="Davies 2005">{{cite book |last1=Davies |first1=AH |last2=Brophy |first2=CM |title=Vascular surgery |date=10 October 2005 |publisher=Springer Science & Business Media |isbn=978-1-85233-288-4 |page=239 |url=https://books.google.com/books?id=s_FcvqJvmhsC&pg=PA239 |access-date=3 February 2022}}</ref> Headhunter, Newton, Simmons, Bentson, and Berenstein catheters are used to navigate the into one of the three branches of the [[arch of aorta]].<ref>{{cite web |title=Angiography peripheral intervention |url=https://www.merit.com/wp-content/uploads/2014/09/PI-Angiography.pdf |publisher=Merit Medical |access-date=4 February 2022 |archive-url=https://web.archive.org/web/20210414170251/https://www.merit.com/wp-content/uploads/2014/09/PI-Angiography.pdf |archive-date=14 April 2021 |page=21}}</ref> Yashiro Catheter is a selective, hydrophilic catheter designed for optimal entry into [[celiac trunk]].<ref>{{Cite journal |last1=Golowa |first1=Yosef S. |last2=Kalva |first2=Sanjeeva P. |last3=D'Othee |first3=Bertrand Janne |date=April 2009 |title=Use of a Yashiro Catheter to Facilitate Complex Visceral Catheterization |url=https://linkinghub.elsevier.com/retrieve/pii/S1051044309000165 |journal=Journal of Vascular and Interventional Radiology |language=en |volume=20 |issue=4 |pages=557–559 |doi=10.1016/j.jvir.2009.01.014|pmid=19243973 |url-access=subscription }}</ref> Whereas endothelial cell sampling through endovascular sampling with coils, stents, stent retrievers, or guidewires suffer from poor selectivity and a low or highly variable cell yield, a micro-3D-printed device adapted for endovascular techniques can harvest endothelial cells for transcriptomic analysis.<ref name="SandellChirehSpyrou2022">{{cite journal | last1 = Sandell | first1 = Mikael | last2 = Chireh | first2 = Arvin | last3 = Spyrou | first3 = Argyris | last4 = Grankvist | first4 = Rikard | last5 = Al-Saadi | first5 = Jonathan | last6 = Jonsson | first6 = Stefan | last7 = van der Wijngaart | first7 = Wouter | last8 = Stemme | first8 = Göran | last9 = Holmin | first9 = Staffan | last10 = Roxhed | first10 = Niclas | title = Endovascular Device for Endothelial Cell Sampling | journal = Advanced NanoBiomed Research | date = 21 August 2022 | volume = 2 | issue = 10 | article-number = 2200023 | issn = 2699-9307 | eissn = 2699-9307 | doi = 10.1002/anbr.202200023 | pmid = | s2cid = 251730092 | url = | doi-access = free }}</ref>

===Balloon catheters===
{{Main|Balloon catheter}}
There are also balloon catheters used in [[angioplasty]] procedures such as plain balloon catheters that is useful in passing tight vessel stenosis, drug coated balloons that contains [[paclitaxel]] on the surface to prevent smooth muscle cells proliferation of the vessel walls, thus reducing the likehood of vessel blockage in the future, high pressure balloons that can open stubborn vessel stenoses in veins and [[arteriovenous fistula]], and cutting balloon angioplasty that contains 3 to 4 small blades on its surface (endotomes) that helps to control the distribution of balloon dilatation more uniformly and cut through resistant stenosis due to fibrous scar tissue.<ref>{{cite book | vauthors = Watson N, Jones H |title=Chapman and Nakielny's Guide to Radiological Procedures |date=2018 |publisher=Elsevier |isbn=978-0-7020-7166-9 |page=231}}</ref>

===Dialysis catheters===
{{Main|Dialysis catheter}}
There is no difference in achieving adequacy of blood flow, period of catheter usage, infection, and thromboembolic risk whether the dialysis catheter has step-tip, split-tip, or symmetrical tip.<ref name="pmid30905366">{{cite journal | vauthors = Ling XC, Lu HP, Loh EW, Lin YK, Li YS, Lin CH, Ko YC, Wu MY, Lin YF, Tam KW | title = A systematic review and meta-analysis of the comparison of performance among step-tip, split-tip, and symmetrical-tip hemodialysis catheters | journal = Journal of Vascular Surgery | volume = 69 | issue = 4 | pages = 1282–1292 | date = April 2019 | pmid = 30905366 | doi = 10.1016/j.jvs.2018.09.029 | s2cid = 85497739 | url = | doi-access = free }}</ref> The Palindrome catheter is superior to Permcath catheter in terms of maximum blood flow, dialysis adequacy, and annual patency rate. Similar to Permcath, Palindrome catheter has a high infection and [[thromboembolism]] rate.<ref name="pmid24685735">{{cite journal | vauthors = Li M, Zhang Z, Yu Y, Chen H, Li X, Ma J, Dong Z | title = Clinical application of long-term Palindrome catheter in hemodialysis patients | journal = Iranian Journal of Kidney Diseases | volume = 8 | issue = 2 | pages = 123–9 | date = March 2014 | pmid = 24685735 | doi = | url = }}</ref>

==Adverse effects==
In interventional procedures, Teflon catheters (which are hydrophobic) have higher risk of thrombus formation when compared to polyurethane catheters. The longer the duration of the catheter left inside the body, the higher the risk of thrombus formation. Larger catheters increase the risk of thrombus formation around the catheter, because they can block the flow of blood.<ref>{{Cite journal |last1=Formanek |first1=Gustave |last2=Frech |first2=Robert S. |last3=Amplatz |first3=Kurt |date=May 1970 |title=Arterial Thrombus Formation During Clinical Percutaneous Catheterization |journal=Circulation |language=en |volume=41 |issue=5 |pages=833–839 |doi=10.1161/01.CIR.41.5.833 |issn=0009-7322|doi-access=free |pmid=5444526 }}</ref>

"Any foreign object in the body carries an infection risk, and a catheter can serve as a superhighway for bacteria to enter the bloodstream or body", according to Milisa Manojlovich, a professor at the University of Michigan School of Nursing.<ref>{{cite web |title=Catheters: Big source of infection, but often overlooked |date=July 1, 2019 |author=Laura Bailey |publisher=[[University of Michigan]] |url=https://news.umich.edu/catheters-big-source-of-infection-but-often-overlooked |access-date=February 16, 2020}}</ref>

Catheters can be difficult to clean, and therefore harbor antibiotic resistant<ref>{{cite web|url=https://mosaicscience.com/story/catheters-foley-uti-cauti-amr-dri-hospital-acquired-bacterial-infection-sepsis |title=Nobody wants to talk about catheters. Our silence could prove fatal &#124; Mosaic |publisher=Mosaicscience.com |date=2018-11-07 |access-date=2019-11-13}}</ref> or otherwise pathogenic bacteria.

==See also==
* [[Cannula]]
* [[Foley catheter]]
* [[French catheter scale]]
* [[Gastrostomy]]
* [[G-Tube]]
* [[Jejunostomy]]
* [[Stent]]
* [[Catheter lock solution]]

==References==
{{reflist}}

*{{cite journal |last=Millward |first=Steven F. |title=Percutaneous Nephrostomy: A Practical Approach |journal=Journal of Vascular and Interventional Radiology |volume=11 |issue=8 |pages=955–964 |date=September 2000 |doi=10.1016/S1051-0443(07)61322-0|pmid=10997456 }}

==External links==
{{Commons category|Catheters}}
{{Wiktionary}}

{{Surgical instruments}}
{{Urologic surgical and other procedures}}
{{Benjamin Franklin}}
                      
[[Category:Catheters|*]]