Experience with a 6 French double loop catheter for right coronary angiography.

A 6Fr double loop diagnostic catheter was developed for angiography of the right coronary artery and tested in 101 patients. Its primary use was employed in 60 patients, and after failure of a 6Fr right Judkins diagnostic catheter in 41 patients. Primary use was successful in 56 out of 60 patients (93%); four failures were cannulated with 6Fr right Judkins diagnostic catheters. After failure of 6Fr right Judkins diagnostic catheters, 36 out of 41 patients (88%) were successfully cannulated with 6Fr double loop diagnostic catheters. Causes of failure of 6Fr right Judkins diagnostic catheters were: inadequate torque control in 24 patients, because of tortuosity of femoro iliac arteries or aorta; dilatation of the ascending aorta, abnormal origin or course of the initial segment of the right coronary artery in 17 patients. Three out of five patients in whom right Judkins diagnostic and double loop diagnostic catheters failed to intubate the right coronary artery were successfully cannulated with 7Fr diagnostic catheters (right Judkins one patient; El Gamal one patient; right coronary bypass one patient). CONCLUSION. 6Fr double loop diagnostic catheters increased the success rate of right coronary angiography after failure of 6Fr right Judkins diagnostic catheters.

Experience with U-shaped catheters in angiography and angioplasty of the left coronary artery.

We developed a U-shaped diagnostic and guiding catheter for left coronary angiography and angioplasty. Angiography with a 6 French (F) diagnostic U-shaped catheter was attempted in 101 patients (pts). Primary use in 82 pts; all successful. Secondary use after failure of 6 F left Judkins diagnostic catheters to intubate the left main coronary artery in 19 pts; 17 successful. An 8 F U-shaped guiding catheter was used for percutaneous transluminal coronary angioplasty (PTCA) of left coronary artery branches in 102 pts [left anterior descending (LAD), 48 pts; circumflex (CX), 54 pts]. Stable cannulation of the left coronary artery was achieved in 96 pts (94%), but PTCA was successful in 90 pts (88%). Primary use in 70 pts (LAD, 27 pts; CX, 43 pts). PTCA was successful in 60 pts. Secondary use after failure of left Judkins and Amplatz guiding catheters in 32 pts (LAD, 21 pts; CX, 11 pts). PTCA was successful in 30 pts. No complications were seen. In conclusion, U-shaped diagnostic and guiding catheters increased the success rate of 1) left coronary angiography after failure of left Judkins diagnostic catheters; and 2) PTCA of the left anterior descending and circumflex arteries after failure of left Judkins and Amplatz guiding catheters.

Experience with a double loop guiding catheter for angioplasty of the right coronary artery.

UNLABELLED: An 8 French (F) double loop guiding (DLG) catheter was developed for percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) and tested in 80 patients: primary use in 59 patients, and after failure of an 8 F right Judkins guiding (RJG) catheter in 21 patients. Primary use resulted in stable intubation of RCA in 55 patients (93%), but PTCA was successful in 50 (91%). Five failures resulted from inability to cross or dilate the lesion. After failure of an 8 F RJG in 21 patients, successful stable intubation of RCA with a DLG was achieved in 19 patients (90%), but PTCA was successful in 17 patients (81%). Failure of RJGs in 21 patients resulted from inability to intubate the RCA in 12 patients, or inadequate back up support by the guiding in 9 patients. CONCLUSION: DLGs increased the success rate of PTCA of the RCA after failure of RJGs.

Shearing of the plastic coating of a hydrophilic guide wire in a right femoropopliteal bypass graft: removal from the contralateral side.

The plastic coating of a hydrophilic guide wire tore off during introduction through a beveled single wall arterial entry needle in a 75 year old male. The sheared piece of coating got stuck in his femoropopliteal bypass. It was removed by means of a modified arterial filter set from the contralateral side. The technique of its removal is described.