Novel Device For Removal of Blot Clot Obstructions in Drainage Tubes

Abstract

Medical drains frequently become obstructed requiring removal or re-intervention. Currently, there is no widely accepted practice for maintaining drain patency. A simple device to remove obstructions from medical drains may have significant benefit. We manufactured a prototype drain clot extractor (DCE) for extracting obstructions. Fresh nonanticoagulated swine blood was instilled within drainage tubes of 16, 20, and 32 French (n = 2 for each size) to generate a 4 cm blood clot. The operator was then equipped with a 0.035 in. guidewire (GW) and given 2.5 min to attempt removal while blinded. Similarly, the operator was equipped with the DCE. Volumes removed were determined by volume displacement and by drain size and method of removal. Comparison of DCE to GW by analysis of variance and means comparison using Tukey were used for statistical analysis. The DCE facilitated mechanical removal of obstructions for 16, 20, and 32 French drainage tubes. Volumes removed: 16 French (GW mean 10% volume, DCE mean 70% volume p = 0.02); 20 French (GW mean 12.5% volume, DCE mean 75% volume p = 0.01); 32 French (GW mean 37.5% volume, DCE mean 100% volume p = 0.01). DCE volume removal had no dependence on drain size (p > 0.05). This device may have utility for reducing morbidity from early drain discontinuation or replacement. Further in vivo and clinical studies are needed to determine the safety, feasibility, and efficacy of this device as tool for removing medical drainage obstructions.