Guide catheters positioning

Y-connector (Fig. 16.18). The latter also allows for continuous flushing of the guiding catheter. Alternatively, a side hole can be created in a diagnostic catheter (at a distance from the tip as determined by the operator), which can serve as an exit for a microcatheter. This technique has been described to be helpful in the embolization of proximal subclavian arterial branches, when stable catheter position cannot be achieved in other ways [21]. In a similar fashion catheters with pre-fabricated side holes can be used in difficult anatomical situations [37]. 

With the guide catheter safely positioned in the coronary sinus and the target coronary sinus tributary identified, the coronary sinus lead can be placed. If a stylet-driven approach is used, success depends on operator experience, skill, coronary sinus anatomy, lead stylet selection and stylet management. Stylet... 

Delivery of an IVC filter requires the filter structure to be collapsed and loaded into a sheath that fits inside a 6-9 French-size (2-3 mm diameter) catheter. A guide wire is first inserted into the vein and its position tracked by radiological imaging. Then the guide wire is used to insert the loaded... 

When a medical prosthesis such as a catheter, guide wire, angioplasty balloon, or stent is inserted to a blood vessel, external force is needed to advance the prosthesis into the right position. Ideally, the force used should be as low as possible to minimize surgeons ... 

Fig. 37.13a,b. Patient (prone position) with a fever showing a presacral fluid collection 10 days after abdominoperineal rectum resection (a). An 8-French drainage catheter was inserted using the Seldinger technique, b Guide wire being introduced through an 18-G sheath under CT fluoroscopy... 

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