1. Wires, Catheters & Supplimentary Equipment
Tortorici Chapter 16 & 17
Guidewires
* Stainless steel
* Solid, or wrapped in
teflon for lower
coeficient of friction.
* Heparin coated
Guidewire tips
* Tapered tip
* Rigid or flexible (floppy)
* “J” measured in radii
3cm ave.
floppy ends
3mm-3cm

2. Guide Wires
2 in 1 wires
* movable core in teflon wrap allows stiffening of floppy end
* Allows for cm flop
* Handle is called a mandril
* Added versitility but increased risk of:
unraveling
clotting
abrasion
flaring of end hole in catheter

3. Guide Wires Length of wires * 30-50 cm for direct vascular puncture
* average
* for catheter exchange
Diameters
* Common diameters .035” ”
.89mm - .97mm
* Range from .014”-.52” ( mm)

4. Guide Wires Wires are matched to * Vessel size (not obstruct)
* Needle gauge (no leaking of heme, no sticking)
* Catheter lumen
On opening package scrub tech inspects:
* Visually
* Tactily
* Bend tip 180o for flexibility

5. Catheters Characteristics * Memory * Torque Types
* Multipurpose (for flush studies)
* Selective
* Super selective
* Deflecting
Made of
* Teflon
* Polyethylene, or
* Polyurethane
* Braided or not
* Radiopaque or lucent
Measured in: French
* Outer diameter
* 1 French = .33mm
(4-5 French ave.)

6. Catheters Tips * Tapered and shaped * End hole only for
selective studies, or
* End and side holes for
large vessels, recoil control
* Side holes only for pulmonary
and ventriculograms

7. One of the Judkins left coronary series One of the Judkins
right coronary series.
Pigtail
To prevent clots, catheters
are flushed with heparinized
saline
Heparin is an anticoagulant
Protamine Sulfate is a coagulant

8. Selecting the right coronary artery
Contrast is black on the
fluoroscopic monitor
Under fluoroscopy, as the tip of the catheter probes the area of the origin of the right coronary artery, it will flip into the vessel when found. A few CCs of contrast, hand injected, verifies placement.

10. Sterile Equipment Packs/ Tray Set-up
Disposable or Reuseable Packs
* Needles, 18 gague, (thin walled or regular) 2 1/8” – 3 ¼”
* Adapters (Male & Female, Tapered, Leur Lok, Tuohy-Borst)
* Stopcocks (2 & 3 way), Manifolds
* Vessel dilator
* Blade
* Forceps
* Extension tubing
* Basins (large and small)
* Towels
* 4 x 4 gauze (sponges)
* Gowns, gloves
Cannula
Baseplate
Hub
Stylet or
obturator

11. Sterile Equipment Packs/ Tray Set-up
Add to Tray
* Antiseptic solution
* Contrast
* Heparinized saline
* Catheters
* Guide wires
* Sheath
* Drape
* Razor (not on tray)

13. Manifold connected to catheter forms a closed system
Strain gauge
transducer
Contrast
Heperinized
Saline flush
Waste fluid
Systolic pressure
measured through
the catheter in the
left ventricle.
Manifold
Syringe for hand injections of
contrast and flushing catheter

14. 1. Which of the following guide wires is best for maneuvering around atherosclerotic
plaque?
2. Angiographic catheters are typically constructed of:
3. Coating a guide wire with Teflon will decrease its:
When changing from a flush to a selective study, the catheter should be twice
the length of the guide wire.
5. A ”38” guide wire would have a diameter of:
6. The typical arteriography needle size used for the Seldinger technique is:

15. 7. Guide wires are typically constructed of:
8. The sharpened, solid portion of a two-part needle is termed the:
9. A 6 F catheter would have an outer diameter of:
10. The ability of a catheter to respond to twisting manipulations is termed:
11. Thrombus formation at the catheter tip can be avoided by:
12. Guide wires are typically constructed of: