Читать книгу Interventional Cardiology - Группа авторов - Страница 97

Since the first human cardiac catheterization, performed by Forssmann in 1929, equipment has undergone considerable evolution and nowadays the miniaturization and refinement of materials allow interventionalists to perform safe and effective selective coronary cannulation also in complex anatomies. The size of sheaths and catheters has seen a dramatic reduction in the last few years: from the 9 French (Fr) guiding catheters used by Gruentzig for the first angioplasties in the late 1970s, now most PCI can be safely performed with a 6 Fr and sometimes 5 Fr guiding catheter using a radial approach [2]; these smaller catheters appear of particular interest in the “transradial era” where transradial PCI has emerged as a gold standard in many centers replacing the transfemoral route in daily practice. Access site, size of the ascending aorta, and origin and take off of the target artery strictly condition the selection of the ideal curve for the catheter. Contemporary diagnostic catheters are preshaped to facilitate intubation of the coronary ostia, in most cases with only minimal catheter manipulation. This facilitates ad hoc angioplasty when angiography shows a suitable pathology, provided that the patient has been adequately informed and prepared.