title: Backup force of guiding catheters for the right coronary artery in transfemoral and transradial interventions.
abstract: OBJECTIVE
  We sought to clarify the mechanisms of backup force for right coronary artery intervention.
  
  
  BACKGROUND
  Backup force of a guiding catheter is important for successful percutaneous coronary intervention (PCI); however, little attention has been given to its mechanism.
  
  
  RESULTS
  Backup force of guiding catheters was measured in an arterial tree model. Judkins R, Amplatz L and Ikari R had greater backup force in the transfemoral intervention (TFI) than the transradial intervention (TRI). The primary attachment site of the catheter was the aortic arch in TFI, but it was the brachiocephalic artery in right TRI. This may be a major reason for the different backup force because generation of backup force is governed by the mechanics of the catheter at the attachment site. The Amplatz L and Ikari R had stronger backup force than the Judkins R both in TFI and in TRI because a slight backward motion of the catheter due to device advancement changed the primary attachment site to the reverse side of the aorta or sinus of Valsalva. The primary attachment site of the Ikari L at the power position was the reverse side of the aorta both in TFI and TRI, which was different from other catheters.
  
  
  CONCLUSIONS
  The primary attachment site of the catheter had great impact on the backup force in right coronary interventions. An understanding of the mechanism by which the guiding catheter works in TRI and TFI may help in choosing an appropriate approach site.
authors.affiliation: Department of Cardiology, Tokai University of Medicine, Isehara, Japan. ikari@is.icc.u-tokai.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
authors.forename: Naoki
authors.initials: N
authors.lastname: Masuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsukage
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ogata
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Tanabe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Morino
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods*; D001011:Aorta; D016122:Brachiocephalic Trunk; D003331:Coronary Vessels; D005263:Femoral Artery; D006801:Humans; D066298:In Vitro Techniques; D008953:Models, Anatomic; D011143:Polyvinyl Chloride; D017534:Radial Artery; D013314:Stress, Mechanical
chemical_list: D011143:Polyvinyl Chloride