Nonvascular Interventions

Session: Educational Exhibit Presentations - Station 8: Neurointerventional Radiology and Nonvascular Interventions

Applications of U-type Tube Drainage Catheters: A Through-and-Through Drainage Solution

Monday, March 6, 2023

5:50 PM – 5:55 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

James Roebker, MD, MBA

Resident, Department of Radiology
University of Cincinnati Medical Center

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

DV

Doan Vu, MD

Professor of Clinical Radiology
University of Cincinnati Medical Center
Lulu Zhang, MD

Assistant Professor of Radiology
University of Cincinnati Medical Center
Abouelmagd Makramalla, MD (he/him/his)

IR Division Chief
University of Cincinnati
Ali Kord, MD, MPH

Assistant Professor of Radiology
University of Cincinnati Medical Center
RR

Ross .. Ristagno, MD

Associate Professor of Radiology
University of Cincinnati

Disclosure(s):

James Roebker, MD, MBA: No financial relationships to disclose

Lulu Zhang, MD: No financial relationships to disclose

Abouelmagd Makramalla, MD: No financial relationships to disclose

Ali Kord, MD, MPH: No financial relationships to disclose

Learning Objectives:

To review clinical settings associated with failure or complication of percutaneous catheter drainage (PCD)

To describe concept of U-type Tube Drainage Catheters (UTDCs) and advantages over traditional PCDs

To discuss indications for UTDCs and fundamentals of post-procedure management

Background:

PCD has a wide range of clinical indications, high success rate, and has replaced surgery as the primary treatment for many conditions. However, catheter-related complications remain an issue for complex collections associated with specific pathologies (including necrotizing pancreatitis or collections associated with fistulae).

UTDC is a large-bore, percutaneous drainage catheter with both catheter ends exiting at the skin surface and the mid-catheter portion with side holes that drain a fluid collection or a visceral cavity. At our institution, UTDC is often used instead of surgical necrosectomy. The two percutaneous openings allow for bidirectional drainage, percutaneous lavage, and extended dwell times with a very low risk of catheter-related dysfunction (internal migration, erosion into adjacent structures, or obstruction).

Clinical Findings/Procedure Details:

The clinical indications, procedural details, and considerations of UTDCs are provided in this exhibit. The UTDC is particularly useful when long-term drainage is needed in a large complex fluid collection. The application of UTDCs is pictorially illustrated in the following categories:

Necrotizing pancreatitis – provide long-term drainage and avoid surgical necrosectomy

Gallbladder – function as a chronic cholecystostomy tube in patients with recurrent tube dislodgement

Biliary obstruction – alternative to internal/external biliary catheter that cannot be placed into small bowel or with recurrent tube dislodgement

Kidney – provide urinary tract drainage in the setting of chronic obstruction

Misc. – drainage of complex pleural effusions, soft tissue hematomas, infected collections

Conclusion and/or Teaching Points:

Certain collections, including those that are multiloculated, phlegmonous, or associated with downstream fistula, are notoriously difficult to treat with traditional PCD

UTDC is an innovative technique with bidirectional drainage technique that extends the therapeutic reach of traditional PCDs

Understanding the advantages, disadvantages, and proper technique of UTDC placement is critical to optimizing its use in patient care