As part of a knowledge-based approach to undertaking percutaneous coronary intervention (PCI), appropriate selection and use of guiding catheters is a fundamental cornerstone in the training and performance of cardiovascular interventions. Correct decision making pertaining to the selection of guiding catheters is recognized as one of the most significant determinants of the success of any interventional undertaking, particularly PCI. Acquisition of cognitive and technical skills required for the development of guiding catheter strategies is critical to successful treatments; hence the aim of this chapter is to provide basic knowledge of guiding catheters, including practical tips on usage.
The differences in functionality between diagnostic catheters and guiding catheters are outlined, with particular reference to their respective design features. Types of guiding catheter, especially with regard to the sizes and shapes currently available, are described in general and in subsequent sections elaborated upon with respect to the selection of appropriate guiding catheters according to the intended target vessel, route of arterial access, patient anatomical factors, and type of interventional devices required. We hope this chapter will enable mastery of a good guiding catheter strategy and technique, as tailored to the individual case, and prove ultimately beneficial to the care of patients.
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