{
    "abstract": "Case reports, tissue pathology, and autopsies have suggested that the hydrophilic polymer coating designed to improve endovascular deliverability and minimize vessel trauma can embolize and be associated with adverse outcomes such as ischemia, infarction, and death. This study sought to determine whether hydrophilic polymers shed off commercially available sheaths in a controlled in\u00a0vitro environment, with the hypothesis that significant differences between coated and uncoated (control) sheaths would be found.\nSix sheaths from each manufacturer, including Zenith Alpha abdominal endovascular stent grafts (Cook Medical), DrySeal sheaths (W.L. Gore & Associates), and Sentrant Introducer sheaths (Medtronic), were tested in an in\u00a0vitro environment. Noncoated Check-Flo performer introducer sheaths (Cook Medical) were used as controls. Each test circuit ran for 150\u00a0minutes at an output of 3\u00a0L/min, the circuit was then drained and the fluid collected. Quantitative analysis included weighing the dried filter paper and using particle size light scattering to quantify the particle size and count. Attenuated total reflectance spectroscopy was also used.\nEach of the three coated sheaths had significantly greater shedding compared with the control sheaths. The Cook Zenith alpha sheath had significantly more residue weight (2.87\u00a0\u00b1 0.52\u00a0mg/L) than the Gore DrySeal (1.07\u00a0\u00b1 0.06\u00a0mg/L) and Medtronic Sentrant introducer (0.98\u00a0\u00b1 0.14\u00a0mg/L) sheaths. The average particle size was not significantly different between the coated and uncoated (control) sheaths. Attenuated total reflectance spectroscopy identified sheath particulate in the Cook Zenith Alpha and Medtronic Sentrant samples.\nPolymer embolization was present and significantly greater in all three commercially available hydrophilic sheaths compared with the control group. Further investigation is needed into the clinical significance of these findings.",
    "authors": [
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Alexa",
            "initials": "A",
            "lastname": "Mordhorst"
        },
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Gary K",
            "initials": "GK",
            "lastname": "Yang"
        },
        {
            "affiliation": "Department of Medicine, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Nicholas",
            "initials": "N",
            "lastname": "Reitsma"
        },
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Jerry C",
            "initials": "JC",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Medicine, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Bei Yuan",
            "initials": "BY",
            "lastname": "Zhang"
        },
        {
            "affiliation": "Department of Chemistry, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Sahib",
            "initials": "S",
            "lastname": "Suri"
        },
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.",
            "firstname": "Joel",
            "initials": "J",
            "lastname": "Gagnon"
        }
    ],
    "conclusions": null,
    "copyrights": "Crown Copyright \u00a9 2023 Published by Elsevier Inc. on behalf of the Society for Vascular Surgery.",
    "doi": "10.1016/j.jvssci.2023.100127",
    "journal": "JVS-vascular science",
    "keywords": [
        "Aneurysm",
        "Clinical engineering",
        "Endovascular aneurysm repair",
        "Heparinized hydrophilic polymer",
        "Postoperative complications"
    ],
    "methods": null,
    "publication_date": "2023-11-06",
    "pubmed_id": "37928834\n28216443\n12772242\n18636015\n19846823\n21741274\n25543660\n19716159\n23403021\n20305613\n31660464\n17268041\n25735934\n21851997\n35573856\n24320006\n34263328\n9403448",
    "results": "Each of the three coated sheaths had significantly greater shedding compared with the control sheaths. The Cook Zenith alpha sheath had significantly more residue weight (2.87\u00a0\u00b1 0.52\u00a0mg/L) than the Gore DrySeal (1.07\u00a0\u00b1 0.06\u00a0mg/L) and Medtronic Sentrant introducer (0.98\u00a0\u00b1 0.14\u00a0mg/L) sheaths. The average particle size was not significantly different between the coated and uncoated (control) sheaths. Attenuated total reflectance spectroscopy identified sheath particulate in the Cook Zenith Alpha and Medtronic Sentrant samples.",
    "title": "Evaluation of hydrophilic polymer embolization from endovascular sheath devices in an in\u00a0vitro perfusion system.",
    "xml": "<Element 'PubmedArticle' at 0x788505c774c0>"
}