Lumen-Following Safety J-Guide for Catheterization of Tortuous Vessels

Judkins, Melvin P.; Kidd, Harold J.; Frische, Louis H.; Dotter, Charles T.

doi:10.1148/88.6.1127

Cited by 38 publications

(3 citation statements)

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“…(.88-.95 mm) fl exible guidewire with a "J" tip is passed through the needle into the arterial lumen [ 30 ]. Heparin coating on the wire reduces platelet adhesion [ 31 ].…”

Section: Vascular Accessmentioning

confidence: 99%

Coronary Angiography

Wilson

2015

Coronary Artery Disease

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“…(.88-.95 mm) fl exible guidewire with a "J" tip is passed through the needle into the arterial lumen [ 30 ]. Heparin coating on the wire reduces platelet adhesion [ 31 ].…”

Section: Vascular Accessmentioning

confidence: 99%

Coronary Angiography

Wilson

2015

Coronary Artery Disease

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“…If an obstruction is encountered, the spring is replaced with a safety j-guide" (6). Cathete rs are "over-bent " to obtain th e necessary " spring" to hold them in position.…”

Section: Tec Hn I Cal Comme Ntmentioning

confidence: 99%

Selective Coronary Arteriography

Judkins¹

1967

Radiology

Self Cite

965

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consistent, rapid selective catheterization of both coronaries with a minimum of catheter manipulation ; takes advantage of the eas e, rapidity of performance, and low complication rate of percutaneous femoral catheterization; facilitates both direct serial and cine filmin g ; and is readily taught to residents, fellows , and practicing angiographers. MATERIALOne hundred consecutive patients between the ages of twenty-one and sixtynine years were examined for suspected coronary dis ease. In each, both coronary arteries wer e selectivel y catheterized from D Fi g. 3. L eft Corollary Catheter Technic, T he guide is removed as the catheter is advanced through th e proxima l descend ing thoracic aorta. A. T he ca thete r is maneuvered to a " relaxed" positio n in th e ao rt ic a rch , clear ed , an d the pat ien t turned 20°R P O. B. Cathet er is adv anced slowly u ntil (C) it d rops into the coron ary orifice. The spring afforded by the seconda ry bend holds t he t ip in the coronar y orifice.D , E , and F . Ca thete r posit ion and the reason for " ca thet er ar ms" of varying len gt hs when used in (D) medium, (E) sma ll, and (F ) poststenotic (large ) aorta. U NTIL rec ently , there has bee n a reluctance to sub ject the coron ary patient to the "added risk " of coronary arteriography . The recognition that coronary arteriography is no more hazardous than select ive cardioangiograp hy, that coronary visualizat ion can depict precisely the presence and ext ent of disease, and that something can be done about coronary artery occlusive disease has exte nded the indications and increased the demand for detail ed coronary delineation.N umerous technics for coronary visualization have been proposed (2,4,5,(8)(9)(10)(11).In general, the various forms of the aortic root flush have been favored in E urope , while more selective technics have gained acceptance in the American centers.The new technic reported here facilitates Letl Right Fig. 1. Catheter Bending Wires. Bend ing wires a re form ed (from 0.038-in . stainless stee l spring wire ) int o the above sha pes. L ef t: d = 4 em (mediu m size), 5.0 em (large size ), or 3.5 cm (small size) ; t = 2 em ; r = 1.1 em. The primary an gle is 90°, t he seconda ry 180 0 , t he rad ius of curv ature of the tertiary curve abou t 10 em. R ight: t = 1.5 ern (mediu m size), 1.0 cm (sm all and large size); the seconda ry curve is 135°and has a radius of 5 to 6 em (small and medium sizes) or 10-1 2 ern (large size) .Fi g. 2. Left and Right Coronary Catheters. The tips ar e 5.5 F and have an LD. of 0.041 in . The body is 8F wit h an l.D. of 0.056 in ., and a 12-strand braid of stainless stee l wire is incorp orated into its wall. The braid insures good t orque control. 1 From the Stella and Ch arl es Gu ttma n In stitute for Vasc ular Res earch t hr ou gh Radiology ( Directo r, Pr of. Charles T . Dotter ), Un iversity of Ore gon Medical School, Portland, Ore.

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“…Obstructive arteriosclerotic lesions of the aorta and iliac arteries have not prevented cerebral catheterization. A lumen-following safety J-guide is used to bypass arteriosclerotic obstacles (4). The availability of one-puncture access to all major cerebral vessels will encourage more thorough angiographic evaluation of cerebral problems when indicated.…”

Section: Imentioning

confidence: 99%