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Core 1 > Day 5: OptiTorque, HeartRail & RunThru > Flashcards

Day 5: OptiTorque, HeartRail & RunThru Flashcards

1
Q

What are the branches of the left coronary arteries?

A

LM - Left Main
LAD - Left Anterior Descending
DIAG - Diagonals
Septals
LCX - Left Circumflex
OM - Obtuse Marginals
Ramus

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2
Q

What are the branches of the right coronary arteries?

A

RCA - Right Coronary Artery
PLA - Posterior Left/Lateral Artery
PDA - Posterior Descending Artery

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3
Q

What artery determines coronary dominance and what part of the heart does it feed?

A

The PDA or Posterior Descending Artery because it feeds the inferior left ventricle.

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4
Q

What is a LV Gram and what does it measure?

A

Left Ventricular Gram: an arterial angiogram of the LV that measures pressures - specifically Ejection Fraction or the heart’s ability to pump blood out to the body.

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5
Q

What does diastolic and systolic mean?

A

Diastolic is the relaxation and filling of the heart chambers, whereas systolic is the contraction and ejection of the heart chambers.

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6
Q

What does AP stand for and where is the ii located?

A

Anterior Posterior and the ii is centered.

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7
Q

What does LAO stand for and where is the ii located?

A

Left Anterior Oblique and the ii is on the left of the patient’s body.

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8
Q

What does RAO stand for and where is the ii located?

A

Right Anterior Oblique and the ii is on the right of the patient’s body.

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9
Q

Where is the ii located in a Caudal view and how do the ribs look?

A

Towards the feet and the ribs will be smiling.

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10
Q

Where is the ii located in a Cranial view and how do the ribs look?

A

Towards the head and the ribs will be frowning.

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11
Q

What artery is almost always closest to the spine on angios?

A

The LCX or Left Circumflex

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12
Q

Typically, what is the best angle to view the LCX?

A

Caudal

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13
Q

Typically, what is the best angle to view the LAD?

A

Cranial

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14
Q

Which quadrant is the LCX most frequently found in?

A

Whichever quadrant the ii is located in.

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15
Q

The RCA will be in a “C-Shape” in what view?

A

LAO

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16
Q

The RCA will be in an “L-Shape” in what view?

A

RAO

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17
Q

During a LHC, what progression of views are the images take?

A

AP >

Left Coronaries >
(includes RAO Caudal & Cranial, AP Cranial, LAO Cranial & Caudal)

Right Coronaries >
(includes LAO Cranial, RAO. AP Cranial)

LV/EF Pressure

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18
Q

What is the difference between a Diagnostic Catheter and a Guide Catheter?

A

Diagnostic has a smaller ID and used primarily for angios ONLY. Guide catheters have a larger ID to facilitate passage of devices and therefore can be used for angios AND interventions.

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19
Q

What is our coronary Diagnostic Catheter family?

A

OptiTorque

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20
Q

What is our coronary Guide Catheter family?

A

HeartRail

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21
Q

What are the 3 main considerations of catheter selection?

A
  1. ENGAGEMENT
  2. MANIPULATION
  3. SUPPORT
22
Q

What are the 2 most common tip shapes for standard catheters?

A

Judkins and Amplatz

23
Q

What are the 3 OptiTorque radial catheter shapes?

A

Jacky, Sarah and Tiger (or TIG)

24
Q

What is the difference between Jacky/Sarah and Tiger(TIG) catheter shapes?

A

Jacky and Sarah are smaller and have an angled tip w/2 side holes, whereas Tiger(TIG) is larger and has an upward tip with 1 side hole.

25
Q

What shapes do we carry in the Femoral OptiTorque Catheters?

A

Pigtail
Judkins L&R
Bypass
Amplatz

26
Q

What is the difference between a Universal Catheter and a Standard Catheter?

A

Universal can access both the left and right coronary arteries with the same device, whereas Standard catheters must be swapped to accommodate which side of the heart you are accessing.

27
Q

What are the 3 primary benefits of Universal Catheters?

A
  1. Decreases case time
  2. Limits catheter exchanges
  3. Engages both LCA & RCA
28
Q

What lengths and Fr size does OptiTorque come in?

A

100 & 110cm lengths, 5&6Fr

29
Q

What does the 1:1 torque feature on OptiTorque mean?

A

Precise manipulation and accurate ostial engagement via the double-braided SS mesh middle construction

30
Q

What are the 3 HeartRail guiding catheter shapes?

A

Left Ikari (universal)
Right Ikari
TIG Mod (universal)

31
Q

What is the primary difference between the L&R Ikari catheters?

A

Right Ikari only has 2 curves, whereas Left Ikari has 3 curves.

32
Q

Why does using an 035 wire while manipulating the HeartRail catheters help facilitate ostial engagement?

A
  1. Straightens the brachiocephalic curve
  2. Provides stability during torque
  3. Directs tip towards ostium
33
Q

What are the 2 primary design features of HeartRail?

A
  1. Dimpled Surface - reduces contact w/vessel to limit friction (not hydrophilic but acts like it)
  2. Brachiocephalic curve - offers back-up support from contralateral wall
34
Q

What is the difference between soft plaque and calcific disease?

A

Soft plaque is more like thrombus or clot and can be more acute. Calcific disease is long standing, hard, and penetrates the vessel layers.

35
Q

What is the difference between eccentric and concentric?

A

Eccentric refers to favoring one side or being imbalanced. Concentric refers to being circumfrential throughout, or all the way around.

36
Q

What is the difference between diffuse and focal?

A

Diffuse refers to something spread out or scattered, whereas focal refers to something more acute or pinpointed.

37
Q

What is the standard coronary guidewire diameter?

A

0.014”

38
Q

What are our 2 workhorse wires?

A

RunThrough EF & Izanai

39
Q

What is our specialty escalation wire?

A

HyperCoat

40
Q

Where would you use a HyperCoat wire?

A

Navigating tortuous calcified lesions in complex cases.

41
Q

Where would you use a RunThrough EF wire?

A

As a go to workhorse wire in any PCI.

42
Q

Where would you suggest an Izanai wire?

A

To an operator that my find a benefit in its differentiating colors for buddy wiring.

43
Q

What is the catchy phrase we use to remember the RunThrough wire family’s best features and benefits?

A

TIP - flexible nitinol core for shape-ability
&
TORQUE - for 1:1 precision, steer-ability and cross-ability.

44
Q

What are the RunThrough wires gram tip weights?

A

RTEF & Izania = 0.6 grams
HyperCoat = 1.0 grams

45
Q

What are the RunThrough wires shaping ribbon lengths?

A

RTEF & Izanai = 10mm
HyperCoat = 14mm

46
Q

What is the RunThrough EF tip measurements?

A

2mm Silicone hydrophobic
24.8cm hydrophilic

47
Q

What is the Izanai tip measurement?

A

25cm hydrophilic M-Coat

48
Q

What is the HyperCoat tip measurement?

A

25cm hydrophilic M-Coat

49
Q

How many markers are on the RunThrough wires?

A

2 on the proximal end of HyperCoat
1 on the proximal end of RTEF
None on Izanai because it is white for visibility

50
Q

What does the DuoCore feature on the RunThrough wires do?

A

DuoCore joins the nitinol core tip with the stainless steel core body in a seamless direct joint for a smooth transition. This enables the 1:1 torque and pushability.

Core 1 (7 decks)

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