Читать книгу Interventional Cardiology - Группа авторов - Страница 98

Judkins curve catheters are used most widely. Judkins left 4 (JL4) would suit the anatomy of most patients although downsizing to JL3.5 may be required in patients with a smaller diameter of the aorta, such as women, while JL4.5, JL5, or even JL6 with longer secondary curves may be required if the aortic root is dilated,. Selective intubation can be encountered when there is a short left main stem (LMS) or separate origin of the left anterior descending (LAD) and circumflex (Cx) arteries, which may necessitate selecting a catheter with an upwards pointing tip (e.g., JL3.5) for intubation of the LAD and a more horizontal tip (e.g. JL4) for intubation of the Cx. Guiding catheter selection for left coronary artery is shown in Figure 4.1.

Figure 4.1 Guiding catheter selection for left coronary artery. (a) Normal: JL4. (b) Dilated root: JL5, VL4, GL4, EBU. (c) Superior origin: AL3, VL4, GL4, EBU, Champ. (d) Short left main: JL4 short tip, JL3.5.