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Cardiac catheters are hollow, flexible tubes inserted through narrow openings into body cavities, ducts, or vessels. They allow injection of fluids, distension of passageways, and access by surgical instruments. The EBU catheter has a long tip and secondary curve opposite the aortic wall for stability when placed in coronary arteries. The appropriate guiding catheter for left coronary artery procedures depends on the size and orientation of the aortic root, choosing from models like JL, AL, or EBU and varying sizes.
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Chronic total occlusion pci
Coronary CTO is characterized by heavy atherosclerotic plaque burden within the artery, resulting in complete (or nearly complete) occlusion of the vessel. Although the duration of the occlusion is difficult to determine on clinical grounds, a total occlusion must be present for at least 3 months to be considered a true CTO. Patients with CTO typically have collateralization of the distal vessel on coronary angiography, but these collaterals may not provide sufficient blood flow to the myocardial bed, resulting in ischemia and anginal symptoms. CTO is clinically distinct from acute coronary occlusion, which occurs in the setting of ST-segment–elevation myocardial infarction, or subacute coronary occlusion, discovered with delayed presentation after ST-segment–elevation myocardial infarction. Clinical features and treatment considerations of these entities differ considerably from CTO.
Among patients who have a clinical indication for coronary angiography, the incidence of CTO has been reported to be as high as 15% to 30%. Patients with CTO are referred for angiography because of anginal symptoms or significant ischemia on noninvasive ischemia testing. Patients who are symptomatic will have stable exertional angina resulting from a limitation of collateral vessel flow to meet myocardial oxygen demand with stress. Of patients referred for PCI in clinical trials of CTO PCI, only 10% to 15% of patients are asymptomatic. It is likewise uncommon for patients with CTO to present with an acute coronary syndrome caused by the CTO itself.
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2 Days Training Module 6..pptx
PTCA, or percutaneous transluminal coronary angioplasty, involves inserting a balloon catheter into the heart through an artery to widen a narrowed coronary artery. The document discusses the hardware used in PTCA procedures, including introducer sheaths of varying sizes, guide wires of different tip flexibility, and balloon dilatation catheters made of compliant, semi-compliant, or non-compliant materials. It also covers intracoronary stents, describing their classification as either balloon expandable or self-expanding, composition, and important mechanical properties like elastic recoil and radial force.
Difficulties in Transradial Intervention ( TRI).
Difficulties in transradial intervention include failure to puncture the radial artery, radial artery spasm, tortuosity or loops in the radial or brachial arteries, use of smaller catheters, difficult coronary cannulation, and challenges during percutaneous coronary intervention. Proper catheter selection based on artery size and anatomy, use of adjunct devices like buddy wires, and deep intubation can help maximize support during difficult cases. Angiography may be needed to guide wiring and balloon crossing in tortuous vessels, and stenting can seal aortic dissections involving the coronary ostium.
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- Guidewires have a central core made of stainless steel or nitinol and a distal tip for visibility.
- Based on tip load, guidewires are classified as balanced, extra support, or floppy. Balanced guidewires are most commonly used.
- Guide catheters are used to support device advancement and injection of contrast. They have stiffer shafts and larger diameters than diagnostic catheters.
- Common guide catheters include Judkins, Amplatz, and extra backup guides which are selected based on aortic width and coronary anatomy.
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- 2. CATHETER • Hollow flexible tube that can be inserted through a narrow opening into body cavity,duct or vessel. • Catheters there by allow injection of fluids distend a passageway or provide access by surgical instruments. • The process of inserting catheter is called catheterisation.
- 27. EBU CATHETER • Long tip catheter • Better support and stability • Long secondary -curve about opposite aortic wall • So tip in the coronary artery not easily displaced and provide a stable platform
- 36. Guiding catheter selection-LCA Aortic root Normal- JL4 Dilated-. JL5,AL2,EBU4 Narrow-. JL3.5,EBU 3.5 Orientation Normal,Anterior- JL,AL,EBU Posterior- AL,EBU Superior- JL,EBU
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