Percutaneous femoral single catheter technique
After a generation of coronary arteriography two basic techniques have evolved, the first being the more traditional brachial and the second the percutaneous femoral artery approach with multiple preformed catheters. Design and performance of these catheters have required consideration of curve and manipulations. The development consideration at this institution involved pursuing a basic percutaneous single catheter through systematic analysis of these existing approaches. Optional designs took into account the problem definition of torque control, catheter stiffness, angle, and tip flexibility, thereby eliminating either a cutdown or many changes with guidewires and preformed catheters.
Fundamentally, a nonspecific curve for selective canalization of both the left and right coronary arteries as well as ventriculography and bypass graft opacification resulted. A polyurethane, 100 cm, No. 8 French catheter with a 45° curve and flexible tip was used.
The technique that evolved was not designed to take the place of, but more to offer an alternative to the already well-established and existing techniques.
The catheter is introduced percutaneously from either the right or left femoral artery by a Seldinger guide. Advancement over the aortic arch is without a guide. Selective canalization of the left and right coronary arteries is made by loops or rotations (Figure). The left artery is catheterized by advancing the tip of the catheter into the noncoronary cusp posteriorly. As the loop is formed, the tip will approach the coronary ostia for opacification. Difficulties may occur in advancing too rapidly with passage of the tip across the aortic valve into . . .