Guide catheters and wires

Summary

Both the guide catheter and the guidewire are essential tools for percutaneous coronary intervention (PCI). Understanding the construction, design features and performance characteristics will facilitate their appropriate selection. A good guide catheter provides coaxial alignment for contrast injection and smooth delivery of the device to the target site. Guide catheters of various sizes and shapes are selected based on vessel anatomy, lesion characteristics, vascular access and procedural complexity. Similarly, guidewire selection is tailored to specific lesion characteristics. As more challenging lesions are attempted percutaneously, improved guidewire technology and their better understanding assume greater importance. Both the guide catheter and the guidewire need to be manipulated with care to avoid iatrogenic complications. Their historical development, present status and future direction are reviewed here.

Guide catheters - Introduction

Besides serving as a conduit for contrast delivery and pressure measurement, an “ideal” guide catheter provides coaxial alignment and support for device passage and advancement to the target site. Compared to diagnostic catheters, guide catheters have a stiffer shaft, larger lumen diameter, and a shorter, non-tapered and less angulated tip (Table GC 1). Catheter tips are usually radiopaque and soft, allowing less traumatic engagement of the vessel ostium. Guide catheters are available...