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Guiding Catheter (guiding + catheter)
Selected AbstractsPercutaneous coronary intervention using a virtual 3-Fr guiding catheter,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 7 2010Shingo Mizuno MD Abstract Background: We have recently reported a novel percutaneous coronary intervention (PCI) system using a hydrophilic-coated sheathless guiding catheter (Virtual 3-Fr, Medikit, Tokyo, Japan), which provides us with less invasive angioplasty and a puncture site injury equivalent to a conventional 3-Fr introducer sheath. Here, we report the initial results of PCI using this novel system. Methods: A total of 36 coronary artery lesions of 27 patients were treated by using a virtual 3-Fr PCI system. Procedural outcomes of virtual 3-Fr PCI were retrospectively evaluated. Results: The mean age was 73.0 ± 8.7 years (range, 46,84 years), and 15 were men (56%). Access sites included the radial artery in 18 patients (67%), the brachial artery in eight patients (30%), and the femoral artery in 1 patients (4%). Among 36 lesions, seven were chronic total occlusions, and a virtual 3-Fr PCI was successful in 33 lesions (92%). Among the successfully treated 33 lesions, coronary stents were deployed in 32 (97%), and intravascular ultrasound examination was performed in 19 (58%). Hemostasis was achieved immediately after PCIs in all cases. No access-site related complications including radial artery occlusion were observed. Conclusions: The performance of a virtual 3-Fr PCI system appears to be comparable to one using a regular 5-Fr guiding catheter while the puncture-site damage remains equivalent to that of a 3-Fr introducer sheath. Virtual 3-Fr PCI may have a potential to serve as a minimally invasive strategy for the treatment of coronary artery diseases. © 2010 Wiley-Liss, Inc. [source] Coaxial double catheter technique followed by buddy wire placement for ostial lesion of right coronary artery with anterior take-offCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 7 2007Shinichi Furuichi MD Abstract This report describes a technique for percutaneous coronary intervention in an ostial lesion with difficult take-off utilising an 8F guiding catheter and a 5F 125 cm-long diagnostic catheter followed by buddy wire placement. © 2007 Wiley-Liss, Inc. [source] Extreme coronary guide catheter support: Report of two cases of a novel telescopic guide catheter systemCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2006Adam T. Stys MD Abstract Extra support of the guiding catheter is required in selected cases of percutaneous coronary intervention (PCI). We describe two successful cases of PCI of very calcified and tortuous right coronary arteries in which a novel telescopic guide system was devised. The system utilizes a long sheath that "armors" the guide catheter. The operator can adjust the support of the guiding system from soft up to extremely stiff. © 2006 Wiley-Liss, Inc. [source] Feasibility and safety of transbrachial approach for patients with severe carotid artery stenosis undergoing stentingCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2006Chiung-Jen Wu MD Abstract Although sporadic successful cases using the transradial approach (TRA) for carotid stenting have been reported, the safety and feasibility of carotid stenting using either TRA or a transbrachial approach (TBA) have not been fully investigated. Recently, we have developed a safe and feasible method of TRA for cerebrovascular angiographic studies. This study investigated whether a TBA approach using a 7-French (F) Kimny guiding catheter for carotid stenting is safe and feasible for patients with severe carotid stenosis. Thirteen patients were enrolled into this study (age range, 63,78 years). Seven of these 13 patients had severe peripheral vascular disease. A retrograde-engagement technique, involving looping 6-F Kimny guiding catheter, was utilized for carotid angiographic study. For carotid stenting, the 6-F Kimny guiding catheter was replaced with a 7-F Kimny guiding catheter, and the procedure was performed as the follows. First, an extra-support wire was inserted into the middle portion of external carotid artery (ECA). Second, a 0.035-inch Teflon wire was advanced into the common carotid artery. Then, the 6-F guiding catheter was exchanged for a 7-F Kimny guiding catheter. Third, if the first and second steps did not provide adequate support for exchanging the guiding catheter, a PercuSurge GuardWireÔ was inserted into the ECA, followed by distal balloon inflation for an anchoring support. FilterWire EXÔ was used in 9 patients and PercuSurge GuardWire in 4 patients to protect from distal embolization during the procedure. The procedure was successful in all patients. No neurological or vascular bleeding complications were observed and all patients were discharged uneventfully. The TBA for carotid stenting was safe and effective, providing a last resort for patients unsuited to femoral arterial access and surgical intervention. © 2006 Wiley-Liss., Inc. [source] Direct stent implantation without predilatation through 5 French guiding catheter following transfemoral coronary angiogram: A feasibility studyCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2003Camille Brasselet MD Abstract Direct stenting (DS) is accepted as reducing procedural cost and duration and 5 Fr guiding catheters as lowering peripheral vascular complications. We aimed to evaluate the feasibility and safety of both strategies. We retrospectively studied 150 consecutive patients treated with DS strategy using a 5 Fr femoral approach. A need for 6 Fr devices or balloon predilatation defined 5 Fr DS failure. Procedural success was defined as good angiographic result (residual stenosis < 30% and TIMI flow 3) without ischemic complications. A total of 161 out of 174 lesions were elected as suitable for DS. The success rate of 5 Fr DS was 87.6% (141/161 lesions). The procedural success rate was 92% (138/150 patients). The angiographic success rate was 96.3% (155/161 lesions). Other complications were six non-Q-wave MI and one repeat angioplasty for acute in-stent thrombosis. Only one major peripheral vascular complication occurred. Direct stenting through 5 Fr guiding catheters in selected lesions is safe and effective with a low incidence of peripheral arterial complications. Catheter Cardiovasc Interv 2003;60:354,359. © 2003 Wiley-Liss, Inc. [source] Cervical epidural analgesia via a thoracic approach using nerve-stimulation guidance in adult patients undergoing total shoulder replacement surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2007B. C. H. Tsui Background:, Continuous cervical epidural anesthesia can provide excellent peri- and post-operative analgesia, although several factors prevent its widespread use. Advancing catheters from thoracic levels to the cervical region may circumvent these barriers, provided they are accurately positioned. We hypothesize that guiding catheters from thoracic to cervical regions using low-current epidural stimulation will have a high success rate and enable excellent analgesia in adults undergoing total shoulder arthroplasty. Methods:, After Institutional Review Board approval, adult patients were studied consecutively. A 17-G Tuohy needle was inserted into the thoracic epidural space using a right paramedian approach with loss of resistance. A 20-G styletted epidural catheter, with an attached nerve stimulator, was primed with saline and a 1,10 mA current was applied as it advanced in a cephalad direction towards the cervical spine. Muscle twitch responses were observed and post-operative X-ray confirmed final placement. After a test dose, an infusion (2,8 ml/h) of ropivacaine 2 mg/ml and morphine 0.05 mg/ml (or equivalent) was initiated. Verbal analog pain scale scores were collected over 72 h. Results:, Cervical epidural anesthesia was performed on 10 patients. Average current required to elicit a motor response was 4.8 ± 2.0mA. Post-operative X-ray of catheter positions confirmed all catheter tips reached the desired region (C4,7). The technical success rate for catheter placement was 100% and excellent pain control was achieved. Catheters were positioned two to the left, four to the right and four to the midline. Conclusion:, This epidural technique provided highly effective post-operative analgesia in a patient group that traditionally experiences severe post-operative pain and can benefit from early mobilization. [source] Blunt atrial transseptal puncture using excimer laser in swine,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2007Abdalla A. Elagha MD Abstract Objectives: We describe a new approach that may enhance safety of atrial transseptal puncture using a commercially available laser catheter that is capable of perforation only when energized. We test this approach in swine. Background: Despite wide application, conventional needle transseptal puncture continues to risk inadvertent nontarget perforation and its consequences. Methods: We used a commercial excimer laser catheter (0.9-mm Clirpath, Spectranetics). Perforation force was compared in vitro with a conventional Brockenbrough needle. Eight swine underwent laser transseptal puncture under X-ray fluoroscopy steered using a variety of delivery catheters. Results: The 0.9-mm laser catheter traversed in vitro targets with reduced force compared with a Brockenbrough needle. In vitro, the laser catheter created holes that were 25,30% larger than the Brockenbrough needle. Laser puncture of the atrial septum was successful and accurate in all animals, evidenced by oximetry, pressure, angiography, and necropsy. The laser catheter was steered effectively using a modified Mullins introducer sheath and using two different deflectable guiding catheters. The mean procedure time was 15 ± 6 min, with an average 3.0 ± 0.8 sec of laser activation. There were no adverse sequelae after prolonged observation. Necropsy revealed discrete 0.9-mm holes in all septae. Conclusion: Laser puncture of the interatrial septum is feasible and safe in swine, using a blunt laser catheter that perforates tissues in a controlled fashion. © 2007 Wiley-Liss, Inc. [source] Direct stent implantation without predilatation through 5 French guiding catheter following transfemoral coronary angiogram: A feasibility studyCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2003Camille Brasselet MD Abstract Direct stenting (DS) is accepted as reducing procedural cost and duration and 5 Fr guiding catheters as lowering peripheral vascular complications. We aimed to evaluate the feasibility and safety of both strategies. We retrospectively studied 150 consecutive patients treated with DS strategy using a 5 Fr femoral approach. A need for 6 Fr devices or balloon predilatation defined 5 Fr DS failure. Procedural success was defined as good angiographic result (residual stenosis < 30% and TIMI flow 3) without ischemic complications. A total of 161 out of 174 lesions were elected as suitable for DS. The success rate of 5 Fr DS was 87.6% (141/161 lesions). The procedural success rate was 92% (138/150 patients). The angiographic success rate was 96.3% (155/161 lesions). Other complications were six non-Q-wave MI and one repeat angioplasty for acute in-stent thrombosis. Only one major peripheral vascular complication occurred. Direct stenting through 5 Fr guiding catheters in selected lesions is safe and effective with a low incidence of peripheral arterial complications. Catheter Cardiovasc Interv 2003;60:354,359. © 2003 Wiley-Liss, Inc. [source] | ||||||||||