Document Type

Article

Publication Date

3-19-2018

College/Unit

School of Medicine

Department/Program/Center

Radiology

Abstract

Hydrophilic polymers are ubiquitously applied as surface coatings on catheters and intravascular medical technologies. Recent clinical literature has heightened awareness on the complication of hydrophilic polymer embolism (HPE), the phenomenon wherein polymer coating layers separate from catheter and device surfaces, and may be affiliated with a range of unanticipated adverse reactions. Significant system barriers have limited and delayed reporting on this iatrogenic complication, the full effects of which remain under-recognized by healthcare providers and manufacturers of various branded devices. In 2015, the United States Food and Drug Administration acknowledged rising clinical concerns and stated that the agency would work with stakeholders to further evaluate gaps that exist in current national and international device standards for coated intravascular medical technologies. The present article reviews current knowledge on this complication as well as factors that played a role in delaying detection and dissemination of information and new knowledge once hazards and clinical risks were identified. Furthermore, organ-specific effects and adverse reaction patterns are summarized, along with implications for device manufacturing, safety testing, and regulation. Particulate analyses and general enhanced processes for device surveillance are needed to optimize vascular technologies and to ensure patient safety.

Source Citation

Mehta RI, Mehta RI. Hydrophilic Polymer Embolism: Implications for manufacturing, regulation, and postmarket surveillance of coated intravascular medical devices. Journal of Patient Safety. March 2018:1. doi:10.1097/pts.0000000000000473

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