title: Enhanced manipulation of directional coronary atherectomy and coronary angioplasty guide catheters.
abstract: Manipulation of thin-walled coronary guiding catheters, especially directional coronary atherectomy guides, may sometimes be difficult. This is particularly so in patients with tortuous or ectatic aorto-iliac arterial systems. To improve torque transmission and eliminate kinking, the introducer catheter or a smaller caliber diagnostic catheter is advanced to within 1.5 cm of the distal guide tip. Connecting the rotating hemostatic valve to the introducer hub or diagnostic catheter proximally allows distal contrast injections and pressure monitoring via this inner catheter. Other methods of enhancing guide catheter manipulation are also discussed.
authors.affiliation: Cardiac Investigation Rooms, Green Lane Hospital, Auckland, New Zealand.
authors.forename: J A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: K
authors.initials: K
authors.lastname: Ng
authors.forename: M W
authors.initials: MW
authors.lastname: Webster
mesh_terms: D017225:Atherectomy, Coronary / Q000295:instrumentation*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000601:surgery*; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans