Catheter types Flashcards
Holes in injection KT: side vs end hole, uses
- Deliver large amount of contrast in small period of time
o Multiple side hole → rapid delivery + KT remain in stable position
o Large diameter (6-7-8Fr) - End hole: not appropriate for ventricuography
o Can cause KT recoil
o If jet hits myocardium: arrhythmias, inadequate contrast dispersion, myocardial staining, perforation
NIH Angiographic
Rigid
Closed/blunt tip w 6 side holes in 1st cm
- Angiography, primarily LV/Ao
- Pressure measurement
Sones KT
End hole + 4 side holes
Tapers to small diameter tip
- LV ventriculography via brachial approach
N Eppendorf KT
No end holes, multiple side holes
- LV ventriculography
Lehman Ventriculography
Semi rigid
Flexible tapered closed tip w 4 side holes
- Pressure measurement, primarily LV/Ao
- Pullback pressure recording
- LV angiography
Cournand Dacron KT
Flexible
End hole only
No balloon
- Pressure measurement, primarily LV/Ao/PCWP
- Blood sampling
Goodale-Lubin
Flexible, open tip w 2 side holes close to tip
- Pressure measurement, primarily LV/Ao
- Blood sampling
Nycor-Pigtail
Semi-rigid, tightly curved w end + multiple side holes
- Angiography, primarily LV/Ao
- Pressure measurement in LV
Advantages of pigtail KT
- End hole: can advance J-tipped guidewire
- Loop: avoid direct contact of end hole + myocardium
- Multiple side holes around loop: numerous path for contrast material dispersion
- Stabilize KT during injection + reduce recoil
- Usually easy to get through AoV, follows direction of flow
- Angled pigtails: 145-155 → pigtail = mimics angle btw Ao root and LV LAX
- Judkins pigtails (original): straight → pig tail
Berman Angiographic
Flexible, closed tip w multiple side holes
4 to 8Fr, requires sheath
Inflatable balloon tip
- Angiography, primarily LV/PA
2 ports
1. Side holes
2. Inflate balloon
Reverse Bearman vs classic
- Reverse: balloon before holes
- Classic: balloon at the end of KT
Balloon Wedge
Flexible, end hole only, inflatable balloon tip
- Pressure measurement, primarily PCWP/RV/RA/PA
- Blood sampling
Swan-Ganz
Flexible, inflatable balloon tip
End hole + thermistor at tip
Proximal side hole 15-30cm from tip
- Pressure measurement, primarily PCWP/RV/RA/PA
- Thermodilution CO measurements
- Blood sampling
What are the 4 lumens of swan ganz KT
- Connected to distal port of KT → measurement of
a. PA pressure when balloon is deflated
b. PCWP when balloon inflated - Attached to T sensing thermocouple 5cm prox to KT tip
a. Measure CO by thermodilution - Connect to port 15cm prox to tip
a. Measure RAP
b. Allows infusion of drugs in central circulation - Inflate balloon
Balloon Tipped Thermodilution KT
End hole w 3 ports and side holes away from tip (RA)
Ballon tip
Thermistor connection site w 2 plugs
- Pressure measurements
- Thermodilution CO measurements