What Is P-CAD and How Does It Work?

The P-CAD, which stands for percutaneous pericardial access device, is an innovative, disposable, all-in-one device that is used for pericardial drain placement and pericardiocentesis: a procedure carried out to drain fluid in the pericardium or pericardial sac.

Surrounding the heart is the pericardium, a protective sac filled with fluid. It is responsible for cushioning the heart, keeping it in place, and preventing it from filling up with fluid and over-expanding. When it fills up with blood or fluid, it constricts the heart and can lead to heart failure. Hence, when the pericardium contains an excess of fluid, it must be drained. The P-CAD is a device created for this purpose.

Developed by AOK Innovations, a company focused on medical product design and development, the P-CAD was designed to simplify pericardiocentesis and percutaneous (performed through the skin), providing cath lab physicians with an advantage.

As an all-in-one device, the P-CAD can be used by itself during procedures. It is useful in treating pericardial tamponade or other atrial compressive conditions associated with congenital heart failure, renal failure, and tumors. Pericardial tamponade, also known as cardiac tamponade, occurs when blood or other fluid accumulates in the pericardium, constricting the heart and resulting in the restricted beating of the heart and lower blood pressure. If left untreated, it can cause the heart to go into cardiac arrest. Its causes include trauma, such as a stab wound or impact from a fall. Medical procedures such as heart surgery and pacemaker placement can also cause heart tamponade.

The handheld device contains a needle, 9-French drainage catheter, self-confirmed syringe, soft-tipped guide wire, and indwelling catheter drainage. With the aid of echo or ultrasound, it can be guided, needle first, to locate a subxiphoid window through which the pericardium can be accessed. It is then inserted into the left shoulder at a 45-degree angle. Blood or fluid from the pericardium is collected in the syringe. This syringe can then be sent to the lab for analysis and culture.

After fluid collection, the guide wire is inserted into the pericardium through the P-CAD’s needle hub, and the needle is removed. As the guide wire is removed, the 9-French drainage catheter is pushed into the skin, and sterile dressings are applied to the area.

The P-CAD is unique; it’s the first and only one of its kind. It allows simultaneous pericardiocentesis and pericardial drain placement. It can be used in emergencies to drain fluid from the pericardium, making it an ideal device for life-threatening situations such as pericardial tamponade. As a disposable device, it does not need to be cleaned after use, eliminating the burden of instrument cleanup after a procedure.

The P-CAD eliminates the need for multiple instruments in procedures such as pericardiocentesis and pericardial drain placement. This will drastically reduce the cost of equipment required for the procedures, as well as the time needed to complete them. Other advantages of the P-CAD include faster procedure times, reproducibility, and simplified design. It can also potentially shorten the duration of patients’ hospital stay.

Built for simplicity and efficiency, the P-CAD is a necessary tool in emergency rooms, catheterization or cath labs, intensive care units, and interventional radiology suites. It is a device that will be an asset in treating pericardial conditions.