Читать книгу Interventional Cardiology - Группа авторов - Страница 118

The advantages and disadvantages of smaller and larger catheter sizes are listed in Table 5.2. Routine angioplasty using 5 French (Fr) guiding catheters may be ideal when direct stenting is planned, but not all stents are deliverable through a 5 Fr guide and most bifurcation techniques are not applicable [1]. The general standard is a 6 Fr (2.00 mm external diameter) guide catheter which permits radial access, allows active engagement (“deep seat”), accommodates two modern rapid exchange balloons or a 1.50 or 1.75 mm rotational atherectomy burr, and uses less contrast than larger catheter diameters. For bifurcation techniques requiring the simultaneous insertion of two stents (Crush, V stenting), 7 Fr (2.33 mm diameter) guides are required. These are necessary for advanced techniques that require two over the wire (OTW) catheters and facilitate the insertion of rotational atherectomy burrs greater than 1.75 mm. For rotational atherectomy burrs greater than 2.0 mm in diameter and complex techniques requiring multiple wires, balloons, and/or stents, 8 Fr (2.66 mm diameter) guides are used. The use of guide catheters greater than 8 Fr is extremely rare in contemporary coronary intervention.

Table 5.2 The advantages and disadvantages of smaller versus larger catheter diameters have to be weighed when selecting catheter size.