Foley Catheter Balloon Research Articles

The effect of plasma low density lipoprotein apheresis on the hepatic secretion of biliary lipids in humans

Background—The liver is a key organ in the metabolism of cholesterol in humans. It is the only organ by which substantial amounts of cholesterol are excreted from the body, either...

Percutaneous Transthoracic Duct Catheterization to the Neck and Esophagus: A Feasibility Study

To assess the feasibility of inserting a drain catheter percutaneously from the cisterna chyli (CC) through the thoracic duct (TD) wall to the neck or esophagus for potential long-term T-cell sampling or drainage in acute or short-term experiments. Percutaneous transabdominal catheterization of the TD from the CC was performed in four animals to insert a 65-cm, 21-gauge needle over a microguidewire. In two dogs, the distal TD was perforated into the neck to connect the TD drain to an access port. In acute experiments on two swine, the esophagus was accessed by puncturing an intraluminal Foley-catheter balloon through the mid TD wall. In one animal, the TD catheter tip was left to drain in the distal esophagus; in the other animal, the catheter distal tip was pulled back through a gastrostomy until the proximal end had retracted into the proximal TD. TD-to-neck port connection was well tolerated short-term. One dog developed dehiscence over the port at 10 days necessitating its removal; in the other dog, the whole drain retracted into the neck from the proximal TD. The technique for TD-to-esophagus catheterization in swine was feasible with no acute complications or mediastinal leakage of contrast medium. Transabdominal percutaneous inside-out TD puncture for drainage to a neck port or to the esophagus is feasible in dogs and swine, respectively.

Management of undeflatable Foley catheter balloons in women.

The inability to deflate a self-retaining balloon catheter is a rare problem but may be encountered by physicians. Many techniques have been described to solve the problem, some of which may be dangerous. The technique must not disturb the patient or create any additional morbidity. Those methods commonly used are the instillation of ether, liquid paraffin, chloroform or mineral oil through the inflation channel the use of a fine wire to burst the balloon or to recanalize the obstructed inflation channel; bursting or deflating the balloon through suprapubic, transvaginal or urethral routes: and the overinflation technique. The techniques which might be most appropriate for women are explained in a stepwise manner. First the catheter is cut in the proximal segment of the valve. If this is not successful, a ureteric catheter stylet is advanced through the inflation channel until it touches the balloon. If this is still unsuccessful, the balloon is deflated through the drainage channel using the technique proposed by Davies and Thomas. As a second choice, an intravenous cannula with its inner needle drawn back is advanced through the urethra next to the catheter; towards the balloon which, is then punctured with the inner needle. If these steps are followed, the patient will have no additional discomfort and no trauma to the surrounding tissues, and there will be no need for cystoscopy or any other expensive intervention.

A penile clamp for retrograde urethrography using external compression by a balloon catheter.

A penile clamp for retrograde urethrography is described. The seal around the fine-bore catheter that injects the contrast is produced by external compression of the penis by the air-filled balloon of a large Foley catheter that acts against counter-pressure from an encircling bandage.

Cervical pregnancy: past and future.

Cervical pregnancy (CP) is a rare life-threatening form of ectopic pregnancy occurring in 1 of 8628 deliveries. We reviewed 117 cases of CP in the English language literature from 1978 and added three cases from our department. Etiology of CP is still unknown, but there is evidence for its association with cervicouterine instrumentation. The possible role of embryo chromosomal abnormality in the CP etiology is considered. Sonography improved pretreatment diagnosis up to 81.8 percent. Obligatory sonographic criteria of CP include endocervical localization of the gestational sac and trophoblastic invasion. About 60 percent of cervical pregnancies are with a viable fetus. The majority of patients with a cervical pregnancy are women with low parity, thus, the current treatment trend is to preserve their reproductive function. The main problem of conservative treatment is life-threatening hemorrhage after pregnancy evacuation. The use of cervical canal tamponade with a Foley catheter balloon led to reliable hemostasis in 92.3 percent of cases in which this method was used. Early diagnosis of CP allowed for treatment by chemotherapy in 32 cases, with an 81.3 percent success rate. Serial beta-human chorionic gonadotropin levels and transvaginal ultrasound with color Doppler are used to monitor therapy. Another conservative treatment modality is local intrasac KCI injections. Hysterectomy is recommended mostly for second and third trimester cervical pregnancy, or for uncontrolled bleeding.

A comparison of various methods to burst Foley catheter balloons and the risk of free-fragment formation.

To compare the efficiencies of bursting balloons and the risks of forming free fragments after rupture using needles, the stylet of a ureteric catheter, instillation with ether or overinflation. Two hundred 18 F 'silkolatex' Foley balloon catheters were divided into four groups of 50. Each balloon was inflated with 30 mL of distilled water, the catheters immersed in urine collected from healthy volunteers and maintained at 37 degrees C for 48 h. Attempts were made to burst the balloons with a needle (group 1), by overinflation (group 2), by ether instillation (group 3) and using the stylet of 7 F ureteric catheter through the inflation channel (group 4). The ratio of the burst to deflated balloons and the formation of free fragments were 100% and 0% in the group 1, 94% and 83% in the group 2, 100% and 100% in group 3 and 16% and 0% in the group 4, respectively. Bursting the catheter balloons using a needle seems to be the most appropriate method, being efficient and having little risk of forming free fragments.

Foley catheter balloon technique for visualizing the hymen in female adolescent sexual abuse victims

Foley catheter balloon technique for visualizing the hymen in female adolescent sexual abuse victims

Technical note: a new device for performing sinograms--the Frank catheter.

Usually sinography is a difficult and messy investigation, in that most of the contrast medium seeps past the Foley catheter balloon and out of the orifice. A new sinogram catheter has been devised to overcome this problem.

Effects of graded upper-airway obstruction on pulmonary mechanics during transtracheal jet ventilation in dogs

To quantify the effects of graded upper-airway obstruction on the delivered tidal volume and selected parameters of pulmonary mechanics during transtracheal jet ventilation (TTJV) in a dog model. Laboratory study in which seven dogs were anesthetized, paralyzed, and placed within a volume plethysmograph with the head and neck externalized. Ventilation was performed using TTJV at 45 psi and a frequency of 15 beats per minute. The upper trachea was occluded progressively using a Foley catheter balloon to induce tracheal pressure levels of approximately 150%, 200%, 250%, and 300% of the tracheal pressure obtained during TTJV-c. Tidal volume, tracheal pressure, transpulmonary pressure, airflow, arterial blood pressure, central venous pressure, and arterial blood gases were measured during all conditions of ventilation. Quasistatic compliance curves of the lungs were measured at the conclusion of spontaneous breathing, TTJV-c, and TTJV (at all levels of obstruction). Minute ventilation and pulmonary flow resistance were calculated for each condition of ventilation. Application of graded upper-airway obstruction during TTJV yielded mean tracheal pressures of 130% (level 1), 190% (level 2), 220% (level 3), and 230% (level 4) of that obtained during TTJV-c (10.9 +/- 2.0 cm H2O). Tidal volume significantly increased with each level of obstruction except between levels 3 and 4 (spontaneous breathing, 506 +/- 72 mL; TTJV-c, 446 +/- 69 mL; level 1, 663 +/- 139 mL; level 2, 780 +/- 140 mL; level 3, 931 +/- 181 mL; and level 4, 944 +/- 135 mL). During TTJV at obstruction level 1, transpulmonary pressure was not significantly higher than either spontaneous breathing or TTJV-c, but did significantly increase during higher levels of obstruction. The mean arterial PCO2 significantly decreased at all levels of obstruction due to significantly increased minute ventilation, with a concomitant increase in arterial pH. There was no significant difference seen in the quasistatic compliance of the lungs among spontaneous breathing, TTJV-c, or TTJV at any level of upper airway obstruction. Partial upper-airway obstruction increases the delivered tidal volume, minute ventilation, and transpulmonary pressure of the lungs during TTJV, with consequent decreases in the arterial PCO2 as the amount of obstruction increases. No significant changes were seen in the quasistatic compliance of the lungs, pulmonary flow resistance, or alveolar:arterial gradient, lending support to the position that TTJV is a safe technique under conditions of partial upper-airway obstruction. However, due to significant increases in tidal volume and functional residual capacity and decreases in mean arterial blood pressure, concerns still exist during near-total or total upper-airway obstruction.

Tamponade of vertebral artery bleeding by Foley's catheter balloon

Tamponade of vertebral artery bleeding by Foley's catheter balloon

Changes in hemodynamic and metabolic parameters following induced brain death in the pig.

Changes in hemodynamic and metabolic parameters (systemic oxygen delivery, [DO2], oxygen consumption [VO2], arterial lactate content) in brain-dead and control pigs in the absence of any inotropic or fluid support were studied. Brain death was induced by the inflation of a Foley catheter balloon placed into the subdural space of the animals. Serial atrial natriuretic peptide (ANP) determinations were performed to evaluate concomitant changes occurring in the endocrine function of the heart. Experiments were completed by a volume expansion protocol to provide a dynamic evaluation of these parameters. A significant increase in heart rate (from 113 +/- 5 to 176 +/- 11 beats/min), pulmonary capillary wedge pressure (from 7 +/- 1 to 12 +/- 3 mmHg), dP/dt (from 2040 +/- 340 to 4200 +/- 660 mmHg/sec-1), cardiac output (from 2.4 +/- 0.2 to 3.3 +/- 0.4 L/min), mean arterial pressure (from 66 +/- 8 to 93 +/- 14 mmHg), and systemic oxygen delivery (from 360 +/- 30 to 530 +/- 90 ml/min-1), was observed following brain death induction. These parameters returned below basal values within 60 min. On the contrary, serum lactate and VO2 remained unchanged. Following volume expansion, brain-dead pigs exhibited impaired hemodynamic response, with a significant decrease in dP/dt, MAP, and DO2. These changes were accompanied by a significant decrease in VO2 and a significant increase in lactate plasma levels. At the same time, a similar increase in ANP release was observed in both groups in response to volume expansion, suggesting that despite impaired myocardial contractility, endocrine function of the heart was preserved following brain death. We conclude that brain death leads to early impaired left ventricular contractility, which could be responsible for the changes observed in aerobic to anaerobic metabolism in response to rapid volume infusion. These results suggest that the use of fluid infusion to reduce the need in inotropic support in conventional therapeutic modalities should be used with care in the management of a brain-dead potential organ donor.

Intraoperative Tissue Expansion with the Foley Catheter

As surgeons face larger and more complex surgical defects, there is the continual search for more practical, successful, and cosmetically elegant methods for repair. Intraoperative tissue expansion is a relatively new technique built upon the fundamentals of traditional chronic tissue expansion. The Foley catheter is an inexpensive, readily available device that can be used for intraoperative tissue expansion. The purpose of this article is to explain and demonstrate some of the uses for intraoperative tissue expansion with the Foley catheter. A series of cycles of inflation and deflation of the Foley catheter balloon allows for gradual stretching of the skin over a period of 15 to 20 minutes. The "tissue gain" achieved via this technique often facilitates wound repair. The Foley catheter is a useful device and a significant addition to the dermatologic surgeon's armamentarium.

The use of Foley balloon catheters in cardiac surgery

Situations may arise during elective and emergency surgery when vascular control is required but conventional vascular clamps cannot be used. We have found the Foley catheter useful for the control of inadvertent perforation of the heart especially in "redo" operations. We describe the use of the Foley catheter for the control of the difficult aorta and illustrate its potential versatility in a variety of uncommon situations. As Foley catheters are present in every operating theatre we hope that our experience will be of benefit to other surgeons who encounter similar problems.

Endoscopic removal of non-deflating Foley balloon catheter.

Endoscopic removal of non-deflating Foley balloon catheter.

Technical aids in investigation and management of urethral diverticula in the female

Three aids in the diagnosis and management of urethral diverticula are described. First, the technique of double-balloon urethrography has been modified. Diluted contrast medium is used to inflate the intravesical and external balloons so that improved delineation of the anatomy of the diverticular pouches is obtained with undiluted contrast medium. Second, for identification and irrigation with antibiotic solution of the nondraining pouches of compound diverticula, an angiographic catheter is placed in the most distal pouch using fluoroscopically guided manipulation, and then this catheter is replaced with a pigtail-shaped nephrostomy drainage catheter. Third, a 7 F Foley catheter balloon is placed in thin-walled and friable diverticular pouches to facilitate dissection.

The use of a tissue expander before complete subtalar release in club-foot surgery

After complication of the surgical full correction of club-foot, primary skin closure may be difficult or even impossible, especially in severe cases and revision operations. This problem is also seen after the complete subialar release technique. To solve this problem we used a tissue expander to prepare sufficient skin to allow pnmary skin closure. The patient was a 36-month old boy. After a normal pregnancy and delivery severe biJateral club-foot was noted at birth. At 24 months bilateral posterior and medial release were performed in another clinic. After one year severe and rigid deformity was repeated bilaterally. At 36 months a complete subtalar release was performed for the righl club-foot in our department. After complelion of the surgical correction we couldn't achieve primary skin closure. For this reason, to prepare sufficient skin to allow primary skin closure, on the lefl foot an expander (balloon of foley catheter, No: 18) was inserted through an incision and placed superficial to the fascia on the distal anteromedial surface of tibia during the same operation. At one week intervals 2-5 ml of saline were added. When we felt that sufficient expansion had been achieved we performed a complete subtalar release for the Ieft club-foot. Primary closure was achieved without tension in the fully corrected position and healing was uneventful. In conclusion, sofl tissue expansion was used Succesfully to prepare the skin before the correction by complele subtalar release of a severe and rigid club-foot deformity.

Latrogenic Obstructive Jaundice Caused by the Balloon of a Foley Catheter

A rare kind of obstructive jaundice caused by compression on the common bile duct due to an inflated Foley catheter balloon placed in the duodenum after Suguira surgery for bleeding esophageal vesicles secondary to portal hypertension is presented. After deflating the balloon, the obstruction was relieved. Tc-99m HIDA studies were helpful in the diagnosis of obstruction of the common bile duct and the response following the deflation.

Emergency management of the nondeflating foley catheter balloon

Inability to remove a self-retaining (Foley) catheter may result from failed attempts to deflate its balloon. In this article, the authors review the causes of inability to deflate Foley catheters as well as the various techniques for their removal.

Heating characteristics of a helical microwave applicator for transurethral hyperthermia of benign prostatic hyperplasia

A new applicator for intraurethral hyperthermic treatment of benign prostatic hyperplasia is described. The applicator uses an insulated helical antenna wound on the outer surface of a silicone urological (Foley) balloon catheter. The balloon catheter assures rapid and reproducible localization of the antenna in the prostatic urethra. Two small cannulae are fixed to the exterior surface of the applicator. One holds a temperature control sensor at a fixed location, the other is used to map temperature along the applicator. Two-dimensional SAR and steady-state temperature distributions measured in a plane tangent to the applicator in a tissue-equivalent phantom are presented, as well as longitudinal temperature distributions measured in situ at the applicator-urethral interface. Prostatic temperatures were also measured intraoperatively. The applicator appears to be capable of elevating temperature to greater than 42 degrees C in a cylindrically symmetric volume of about 4 cm length and about 0.5 cm radial penetration surrounding the antenna. The heating characteristics of this applicator are similar to an earlier design that employed an array of three dipoles. The helical applicator is narrower, more flexible and simpler to use than the earlier design.

Removal of obstructed Foley catheter from the urethra

This case illustrates an approach to resolve a frustrating problem associated with Foley catheter balloon obstructions. By identifying its position in the urethra, the balloon can be deflated with minimal effort and limited urethra injury, using the suggested technique of transperineal needle insertion.