Background: The invention of percutaneous drainage of abnormal fluid collections is responsible in replacing the traditional incision and drainage done surgically. The study was conducted to compare the performance characteristics of pigtail versus J-tip drainage catheters as well as the incidences of failure to drain, catheter-related complications and pain associated with the catheters.
Materials and Methods: A total of 53 subjects referred to the Vascular and Interventional Radiology Section of the Philippine Heart Center for percutaneous drainage of an abnormal pleural or abdominal fluid collection were included based on the inclusion and exclusion criteria. Subjects were randomized to receive either a J-tipped catheter or pigtail catheter through block randomization by blocks of 10. Twenty-six subjects received the pigtail catheter while the remaining 27 received the J-tip catheters. Standard Seldinger technique for drainage catheter insertion was followed. The flow rates, incidence of failure to drain, incidence of catheter-related complications and pain associated with the catheter were noted.
Results: Majority of the catheters were placed in the chest (85% and 81% for pigtail and J-tip catheters, respectively) and majority were of the simple type of fluid collection (81% and 56% for pigtail and J-tip catheters, respectively). Majority of the subjects (54% and 52% for pigtail and J-tip catheters, respectively) had malignancy. The mean flow rate for the Fr 8 catheter was 127.5 ± 5.49 ml/min (pigtail) and 114 ± 5.68 ml/min (J-tip) while the mean flow rate for the Fr 10 catheter was 220 ml/min (pigtail) and 213.57 ± 10.82 ml/min (J-tip). No observations can be made in the Fr 6 and Fr 12 groups due to small sample. A total of 7 out of 27 J-tip catheters (26%) and 5 out of 26 (19%) pigtail catheters had incidence of failure to drain, but these were not significant. There were no catheter-related complications noted for either catheter tip type. Pain associated with the catheter ranged from tolerable to mild pain (1.61 ± 0.64 in the pigtail group and 1.70 ± 0.61 in the J-tip group), which were not statistically different.
Conclusion: Catheter tip shape does not influence the incidence of kinking/clogging, incidence of catheter-related complications and associated pain as well as in the incidence of inadvertent pullouts. Though there was significant difference in the flow rates between the Fr 8 pigtail and J-tip catheters, this cannot be construed as definite evidence that catheter tip shape influences flow rates since no significant difference can be seen in the Fr 10 catheters and no observations can be made in the Fr 6 and Fr 12 catheters.