The guide wire is one of the basic instruments for coronary artery intervention, used to enter the coronary artery or cross the tortuous, calcified, stenosis, collateral circulation to reach the target, and establish a track to deliver balloons, stents and microcatheters. It is used for guide wire upgrade or downgrade technology to open coronary occlusive lesions; to enter coronary artery branches in advance for protection and road sign functions, etc.
Angiography guide wire is a major branch of interventional guide wire. There are two commonly used angiography guide wires in clinical practice. One is super-slip guide wire, also known as loach guide wire, and the other is J-type guide wire, also known as diagnostic guide wire.
The front end of the J-shaped guide wire is bent in a J shape. Its advantage is that the front end of the guide wire will not push against the wall of the blood vessel when encountering a bent and deformed blood vessel during intubation, thereby preventing damage to the blood vessel.
The ultra-smooth guide wire is also called loach guide wire because of its black appearance.
The guide wire hardness is divided into ordinary type, soft type and super hard type. The guide wire tip can be divided into straight head shape and curved J shape. Commonly used is the J-type guide wire of ordinary hardness.
Coronary Angiography Basic Procedures
1. Introduce contrast catheter
Insert the angiography guide wire through the arterial sheath, send the angiography catheter along the guide wire, and perform left ventricular angiography and aortography first to see if there are other diseases. Then angiography was performed at the left and right coronary openings of the aortic root to show the overall situation of the coronary arteries, determine the stenosis location, scope, and degree, and evaluate the collateral circulation.
2. Introduce the guiding catheter and guide wire
The angiography catheter was removed along the angiography guide wire, and the guide catheter was introduced to the treated coronary artery opening. A coronary guide wire was fed along the guiding catheter, and then the balloon was moved along the guide wire to 1 cm from the port of the guiding catheter. Secure the balloon catheter and rotate the guidewire into the target vessel, through the stenosis, and to the distal end of that vessel.
3. Push the balloon to the stenosis
The balloon catheter is advanced along the guide wire, and once it is accurately positioned in the middle of the stenosis, the balloon is inflated with a pressure pump, compressing the vessel wall at the stenosis to rupture the plaque.
4. Stent feeding
Withdraw the balloon catheter, retain the guide wire and guiding catheter, send the pre-installed balloon catheter along the guide wire to the stenosis, use the pressure pump to inflate the balloon, and open the stent. If two stents need to be implanted for a long lesion, the first stent should be placed at the distal end of the lesion first, and the distal end of the second stent should be closely connected to or slightly overlapped with the proximal end of the first stent.