Ostial or proximal segment can be pointed upwards, downwards or horizontally.Locations of the ostia can be low, high or more anteriorly or posteriorly oriented Segment between the primary and secondary curve of the Judkins left guide should fit width of ascending aorta ex:3.5 cm,4 cm, 4.5 cm.orientation of the coronary artery segment proximal to the target lesion.location of the ostia to be cannulated.knows where to go unless thwarted by the operator.Engage the LM ostium without much manipulation.As 1⁰ curve fixed Intubates small segment of ostium - ↓risk of trauma.Primary (90º), secondary (180º), and tertiary (35º) curves fit aortic root anatomy.LIMA catheter for - right and left coronary bypass graft.Others include - Multipurpose for RCA bypass or a high left main (LM) takeoff.Judkins, Amplatz, and Extra-back-up guides.Degree of tortuosity and calcification of the coronary artery segment proximal to the target area.Location and orientation of the ostia to be cannulated.Reduction in back up support provided because of weakness of catheter shaft and the kinking at side holes Indian Heart J.False sense of security because now, aortic pressure, and not the coronary pressure is being monitored.Avoid catastrophic dissections in the ostium of the artery Disadvantages.Allow additional blood flow out of tip, to perfuse the artery.Prevent catheter damping (occlusion of the coronary ostium).Side hole vs no side hole Side holes are useful where the pressure gets frequently damped as in RCA interventions, CTO interventions or sole surviving artery or left main interventions Advantages Easy to handle, torque control, kink resistance.Preformed curves & configurations, optimum support.Ĭross section of catheter Strength Support/Flexibility Kink resistance Polyurethane or Polyethylene 1:1 Torque Kink resistance Stainless steel/ Kevlar Internal lumen Smooth or lubricious material Device compatibility PTFE (Polytetrafluoroethylene) like Teflon.Catheter size in French For each given size - ID is either standard, large or giant.Shorter & more angulated tip (110º vs.
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