Pigtail Catheter and Modifications

Transcript of the video: Pigtail catheter, as the name implies, has a curve at its tip, resembling the tail of the pig. Typically it is a left heart cathter, used for angiography, but there are other uses as well. There are several modifications of pigtail catheter, also used sometimes. Other than angiography, pigtail catheter is used in cardiology for drainage of pericardial effusion. Similar shaped catheters are used for drainage of pneumothorax, pleural effusion and ascites. Even for nephrostomy, a similar catheter is used. But it is of higer diameter, unlike the cardiology pigtail catheter.

This is the curved region of the pigtail. Pigtail has end hole and multiple side holes. So when a pressure injection is given into the left ventricle, there is no single jet going to strike the left ventricular wall and stain the left ventricular wall which can cause arrhythmia. The end hole is not directed directly towards the left ventricular wall. Then there are multiple side holes also there. So the pressure is distributed, staining is avoided and recoil of the catheter during injection is also avoided, reducing the chance for ventricular ectopy, which is an important problem in left ventriculograpy. When there is ectopy, there is a chance for spurious mitral regurgitation to occur during left ventriculography. A disadvantage of pigtail is that, as it has multiple side holes on the way, if you try to record left ventricle to aorta pullbacked (error) pullback tracing of pressure, then this will not be ideal. When the tip is in the left ventricle, this region will be in the aorta sometimes. So it will not produce a true LV to aorta pullback tracing, which is required in cases like aortic stenosis. For that you will have to use a catheter without side holes like this, like a multi-purpose catheter or some other catheter you have to use. Or you can use right coronary angiography catheter. So pigtail is not useful for LV aorta pullback pressure tracing recording.

While standard pigtail catheter is mainly used on the left side, Grollman PA is a catheter used for pulmonary angiography, on the right side. It has a gentle curve here and almost a right angled curve just before the multiple side holes. It is used for pulmonary angiography by the transfemoral route and it is also used for clot lysis in pulmonary embolism. So it is used both diagnostically as well as therapeutically. A similar catheter without the angulation has been called as the Eppendorf catheter.

This is another angled pigtail catheter. You may note that the angle is in a direction opposite to what was seen for the Grollman catheter. This is mainly for left sided use and some of these types of catheters have been used for transbrachial angiography of the aorta and even up to femoral.