Guide Catheters: Selection, Support, Extension and Guide Wire Selection

Abstract

Guide catheters are the conduits through which devices essential for percutaneous coronary intervention can be introduced into the coronary artery. Their primary role is to provide adequate support for the procedure and enable delivery of equipment with simultaneous contrast injection and pressure monitoring. The ideal guide catheter should have the following features: strength, atraumatic support, kink resistance, 1:1 torque, flexibility, device compatibility, a large lumen, and lubricity. Though not all of these features can be obtained in a single guide catheter due to competing dynamics, most of these are achieved by the three-layered structure made of inner lumen, a middle layer of braided steel matrix, and an outer jacket made of soft nylon elastomer. The middle and outer layers provide the torque and support while the inner layer provides minimal resistance and friction for the passage of devices.