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Access Diameters & Lengths > Access > Flashcards

Access Flashcards

1
Q

Standard access vs Tri-axial access

A

Standard: Short Femoral Sheath, Standard Guide Catheter, Microcatheter, Guide Wire

Tri-axial: Long Sheath, Intermediate catheter, Microcatheter, Guide wire

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2
Q

Initial Femoral Artery Guide Wire size?

A

.035”

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3
Q

What is OD measured in?

A

French (F)

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4
Q

What is length measured in?

A

Centimeters (cm)

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5
Q

What is ID measured in?

A

Inches (in)

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6
Q

Minimum Clearance definition

A

The minimum amount of space you must have left over on the sides of the catheters to inject contrast or flush saline

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7
Q

Parallel technique definition

A

Putting two catheters side by side inside of another catheter

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8
Q

Total catheter length = ?

A

Working length + Strain relief + hub

(Strain relief + hub = 6)

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9
Q

Catheter Stability

A

The ability of the catheter to stay within the aneurysm (or in place)

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10
Q

Catheter Trackability

A

Measure of how the catheter navigates over the wire and within the anatomy

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11
Q

Pushability

A

Measure of the amount of force transmitted to the distal end of the catheter when push force is exerted at the proximal end

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12
Q

Tip softness

A

The amount of force the catheter tip exerts against the vessel before buckling

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13
Q

Kink resistance

A

How well the catheter maintains its lumen when in a bend

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14
Q

Tip shapeability

A

The ease with which the catheter tip takes a specific shape when steam or heat is applied

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15
Q

Shape retention

A

The ability of the catheter tip to retain steam-shaped or pre-shaped configurations

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16
Q

Durometer

A

The stiffness of the catheter material.

Higher durometer=improves shape retention & stiffness

Lower durometer=increases softness & flexibility

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17
Q

Taper

A

Varies the thickness if the microcatheter wall.

Thinner wall= softer, more flexible
Thicker wall= better shape retention

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18
Q

Basecamp definition

A

-Guide catheter or long sheath typically places in the common carotid or proximal ICA.
-Greater than or equal to 5F.
-“base” conduit for smaller delivery catheters

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19
Q

Guide catheters:

A

-Balloon, standard, & intracranial guide catheter.
-standard access
-sized by OD (COD: Catheter OD)
Stryker: Guider Softip Guide Cath., Merci BGC, Flowgate2 BGC

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20
Q

Long Sheaths:

A

-Tri-axial approach
-sized by ID (SID: Sheath ID)
Stryker: AXS Infinity LS (Plus)

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21
Q

What are some stryker intermediate catheters?

A

Cat 5,6,7
Vecta 71,74
DAC family

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22
Q

3 goals of intermediate catheters:

A

-Reach the target
-Provide distal stability
-Smooth device delivery & direct aspiration when needed

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23
Q

4 Goals of a microcatheter:

A

1) reach target site
2) maintain stable positioning
3) offer low friction & large lumen
4) provide a fluoroscopic reference

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24
Q

Stryker microcatheters:

A

Excelsior SL-10
Excelsior 1018
Excelsior XT17 & XT27
Trevo pro 14 & 18
Trevo Trak 21

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25
Q

Reinforcement

A

Provides catheter support, stiffening it for increased pushability, and helps improve kink resistance

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26
Q

PTFE lined inner lumen

A

Enhances smooth delivery of devices within Microcatheter lumen

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27
Q

Hyrdrophilic coating

A

Facilitates advancement through challenging anatomy

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28
Q

True or False: intermediate catheters improve distal navigation and better 1:1 handling of the guide catheter

A

False: it helps improve distal navigation and better 1:1 handling of the microcatheter

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29
Q

Which is not a common design of a microcatheter?
A) ptfe lined inner lumen
B) hydrophilic coating
C) edgeless tip
D) radiopaque markerbands

A

C) there are no edgeless tips however they are steam-shapeable

30
Q

3 key messages of AXS Infinity LS?

A

1) rapid access
2) stable platform
3) large .088in lumen

31
Q

3 key messages of AXS Infinity LS Plus?

A

-Distal for more support
-reliable in challenging anatomy (14.5mm flex zone)
- fit more inside (.091”) (without increasing OD)

32
Q

Which of the following can be delivered though AXS Infinity LS Long Sheath?
Trevo nxt + cat 6
Surpass evolve + cat 5
Target coils + transform

A

All of the above

33
Q

3 key messages for Cat 5 (115cm)

A

1) Superior trackability
2) Stable delivery
3) Reliable Design

34
Q

3 key messages for CAT 5 (132cm) & CAT 6?

A

1) superior trackability
2) resilient & reliable
3) optimized for stroke intervention

35
Q

3 key messages for Cat 7?

A

1) transitionless reinforcement (smooth trackability)
2) .068 ID (more aspiration power to injest clot)
3) compatible with Flowgate2 BGC

36
Q

CAT 7 has ______, designed to _______

A) an edgless (rounded) tip; for smooth Trevo retrieval
B) a tapered tip; smoothly navigate tortuosity
C) an edgless (rounded) tip; smoothly navigate tortuosity
D) a tapered tip; for smooth Trevo retrieval

A

A) CAT 7 has an edgeless (rounded) tip, designed for smooth Trevo Retrieval

37
Q

Steam shapeable/Pre-shaped tip

A

Enhances vessel selectivity and helps maintain position in aneurysm during coil delivery

38
Q

Transparent hub

A

Allows direct visualization of device and guidewire introduction (microcatheters)

39
Q

Precisely placed markerbands (microcatheters)

A

Allows user to locate microcatheter and facilitate proper detachment of coils & other devices

40
Q

What is Excelsior 1018 known for?

A

Broad Compatibility

(accommodating different GW & facilitates to the majority of anatomical locations)

41
Q

What is SL-10 known for?

A

Optimized flexibility

(access distal vasculature & have broad device compatibility - delivers target coils and atlas stents)

42
Q

What is Excelsior-XT 27 designed for?

A

Accurate deployment

(Easier access, improved stent deployment, superior stent deployment accuracy)

43
Q

What is XT-17 known for?

A

Versatile platform, smooth tracking & stable delivery

(Good for delivering contrast agents, target coils, atlas stents)

44
Q

Guidewires are used to:

A

-track through vasculature
-access small distal arteries and/or aneurysms
-cross clots or lesions
-support delivery of interventional devices

45
Q

Torque

A

Force required to rotate an object about an axis

46
Q

Tactile feedback

A

How the device feels and responds to maneuvering by the operator

47
Q

5 building blocks of guidewires:

A

1) Coating
- lubricious substance that coats the wire to decrease surface friction
2) Cover
- The cover or jacket placed over the distal tapered section of the core of the wire
3) Core Taper
- The grind of taper applied to the distal end of the core wire metal
4) Core Diameter
- The diameter of the guidewire at its full untapered or ground down size
5) Core Material
- Metal used to create the base or “core” of the guidewire

48
Q

3 common core materials:

A

1) NiTi (nitinol titanium)
2) Stainless Steel
3) a hybrid of NiTi & S.S.

49
Q

3 types of core tapers:

A

1) Linear (more supportive)
2) Step Taper (moderate support)
3) Multi-Step Taper (more flexible)

50
Q

Synchro2 Guidewire benefits?

A

1) innovative torque control
2) reliable stability & flexibility
3) standard, soft & support profiles

51
Q

Which of the following coatings are on Synchro2 guidewires?

A) hydrophilic coating on distal 50cm
B) hydrophilic coating on prox 50cm
C) PTFE coating on the prox shaft
D) PTFE coating on the distal shaft
E) it is uncoated

A

A & C

Hydrophilic coating on the distal 50cm & PTFE coating on the proximal shaft

52
Q

Select all that create Synchro2 guidewires soft tip:

A) tapering the core wire down to .002in
B) increasing the number of slits in the hypotube
C) decreasing the number of slits in the hypotube
D) tapering the core wire down to .005in

A

A & B

Tapering the fore wire down to .002in & increasing the number of slits in the hypotube

53
Q

True or false: the microfabricated distal nitinol hypotube and gentle tip technology are included in all Synchro2 guidewires.

A

True

54
Q

True or false: the synchro2 soft guidewire has a softer tip than the synchro2 support

A

False

55
Q

The 215cm access length Synchro2 guidewire come in which of the following support profiles?

-Standard
-Soft
-Support

A

Support

56
Q

What level of guidewire support is needed for each catheter system?

A) stent retriever w/ Cat6
B) Coil case w/ SL-10
C) Aspiration w/ Vecta 71/74

A

A) Medium
B) Low
C) High

57
Q

Which of the following Synchro2 guidewires was designed to ease trackability of large bore catheters?

Synchro2 soft
Synchro2 Standard
Synchro2 Support

A

Synchro2 Support

58
Q

Which of the following do you think are benefits of having a more supportive guide wire?

A) Better rail over which to deliver large bore catheters
B) lifting the catheter away from branching arteries
C) Easier to torque

A

A & B

Better rail over which to deliver large bore catheters & lifting the catheter away from branching arteries

Easier to Torque is not a benefit

59
Q

Synchro Select 3 benefits:

A

1) improved tip shape retention
2) softer tip
3) overall enhanced control

60
Q

Synchro Select Soft used for:

A

-Better torque control
-navigation of distal anatomy

61
Q

Synchro Select Standard used for:

A

-a workhorse for most cases
-excellent control & trackability

62
Q

Synchro select support used for:

A

-large/stiff device delivery
-large bore aspiration catheters

63
Q

How was tip shape retention enhanced on synchro SELECT?

A) improving the core wire processing
B) updating the cut pattern on the nitinol hypotube
C) both A & B

A

C) both A & B

Improving the core wire processing & updating the cut pattern on the nitinol hypotube

64
Q

Synchro select has a __% softer tip than Synchro 2

A) 22%
B) 12%
C) 34%

A

A) 22%

65
Q

T or F: the pre shaped profiles of Synchro SELECT can be further shaped by physicians

A

True

66
Q

T or F: Synchro Select Support has a stiffer tip than Synchro Select Soft.

A

False

If it navigates better it has a stiffer tip

67
Q

Which of the following enhancements leads to overall improved control? (Select all that apply)?

A) reversing helix cut pattern
B) conventional technology
C) improved core wire

A

A & C

Reversing helix cut pattern & improved core wire

68
Q

Synchro SELECT access length is?

A) 200cm
B) 215cm

A

215cm

69
Q

Which Synchro SELEXT profile should you choose for the best possible microcatheter trackability?

A) Soft
B) Standard
C) Support

A

C) Support

70
Q

Which Synchro SELECT profile should you use for the best possible Torque?

A) Soft
B) Standard
C) Support

A

A) Soft

71
Q

Synchro SELECT has improved tip shape retention compared to Synchro2. By how much have we reduced the tip shape loss?

A) 18%
B) 20%
C) 28%

A

C) 28%

Access Diameters & Lengths (2 decks)

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