Mohammad Shafiqur Rahman Patwary
Sir Salimullah Medical College and Mitford Hospital, Bangladesh
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Appropriate guiding catheter selection is critical to ensure successful percutaneous coronary intervention .It is often the difference between a successfully executed procedure and a failure. Currently a variety of guiding catheters are available, each with a unique design and construction, which has vastly improved the technique of PCI. In general larger sizes allow for better opacification of the contrast, better guide support and allow pressure monitoring, albeit at a cost of increased risk of ostial trauma, vascular complications and the possibility of kinking of catheter shaft. Larger lumen diameters are mandated when using bulky interventional devices like rotablator, laser, atherectomy catheter, some vascular protection/imaging devices or some special interventional techniques like kissing balloon or kissing stent. Choice of Guiding Catheters depends on the size of aorta, location of ostia on the aorta, the kind of back-up required and whether the artery arises from a normal origin or anomalously. For optimal stent delivery, good guide support is necessary. Good guide support revolves around the ability of the guide catheter to remain in position and to provide appropriate stability for the advancement of interventional equipment. Two types of backup support exist: passive and active backup. Passive backup usually relies on the property of the shaft and tip to maintain position at the ostium. On the other hand, active backup catheters use the aortic root to accomplish a desired shape and to provide support, which requires a fair amount of active manipulation by the operator to obtain a stable position coaxially. With the transradial approach, active support of the guiding catheter plays a more important role than with the standard femoral approach.