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Set 16, 2022

Silicone and polyurethane catheters: the comparison

Power injectable central venous catheters in polyurethane are currently the most used medium-long term devices and are preferable to silicone ones for several reasons.

As also reported in the "GAVeCeLT Recommendations 2021 for the indication, implantation, and management of venous access devices," although silicone has no advantage over polyurethane in terms of risk of infectious or thrombotic complications, it does have a high risk of mechanical complications (dislocations, ruptures, tip migration) due to the greater fragility of the material.

Let's see, below, the main differences between silicone and polyurethane catheters.

Silicone and polyurethane catheters: the differences

Silicone catheters are characterized by absolute chemical neutrality and good resistance to bacterial adhesion. However, they also present several problems. For example:

  • manufacturing with large gap between outer and inner diameter;
  • with the same caliber as those in polyurethane, the wall is thicker;
  • they can be more rigid and brittle depending on the percentage of barium;
  • they are sensitive toward solvents (ether, acetone);
  • they have a pressure resistance of only about 40-60 psi;
  • they have a greater tendency to kinking;
  • probable rupture during removal (they denature over the years).

On the contrary, third-generation polyurethane catheters have modulated stiffness, that is, they are stiffer during insertion and softer when in place, for better patient comfort. They have a less thick wall and smaller diameter than silicone ones and provide:

  • greater resistance to tension and breaking loads of the catheter and connections;
  • greater resistance to intraluminal pressure stress (300 psi);
  • high flows (5 ml/s) for the same vascular size;
  • less surface grip;
  • less endothelial friction and better management of occlusive complications;
  • less endothelial pressure trauma.

In addition, with the microintroduction kit, catheter insertion is less traumatic.

Power injectable polyurethane and silicone catheters: other aspects to consider

Are polyurethane catheters suitable for the use of alcohol-based chemotherapeutics (taxanes) or is it better to prefer silicone ones?

In the presentation "Silicone versus Polyurethane Catheters "1, three considerations on the topic are given:

  1. although polyurethanes are theoretically more sensitive than silicone to the effect of alcohol, damage to catheters has never been demonstrated (either in vivo or in well-conducted in vitro studies);
  2. third-generation polyurethanes (e.g., Carbothane), like those used for power injectable PICCs, are resistant to alcohol;
  3. the real risk of rupture from mechanical stress due to the fragility of silicone is much greater than the theoretical risk of injury from chemical damage.

Furthermore, there is no evidence that silicone PICCs have any advantage or preferential indication over polyurethane. Instead, there is evidence that silicone devices limit catheter performance and increase the risk of mechanical complications. In the GAVeCeLT 2021 Recommendations2 for the prevention of mechanical complications, for example, it is indicated:

  • use only power injectable polyurethane catheters;
  • never use silicone catheters.

Also for the prevention of occlusions of the lumen of venous accesses, moreover, the recommendations are to always use power injectable polyurethane external catheters; do not use silicone catheters and valved catheters.

Delta Med central venous catheters are made of P-PUR and ensure reliability, safety and comfort. To learn more, discover our main products here or contact us without obligation for more information from one of our professionals.

 

Sources:

1 Raccomandazioni GAVeCeLT 2021 per la indicazione, l’impianto e la gestione dei dispositivi per accesso venoso, cura di Mauro Pittiruti e Giancarlo Scoppettuolo;

2 Cateteri in Silicone versus cateteri in Poliuretano, Dott.ssa Clelia Zanaboni, IV Convegno Nazionale GAVePed.

 

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