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Toolbox: Wire Selection

  • A J-wire can be used for more selective engagement of coronaries through the Core valve frame.
  • It is very useful in finding the diamond in front of the ostia and the catheter can be railed over it for coronary engagement.
  • If a J-wire fails, a stiff angled glide wire (Terumo Cardiovascular Systems, Elkton, MD) can be used to find the diamond in front of the ostia and the catheter can be railed over it for the engagement.
  • As it is more lubricious, it can more easily enter the diamond of the frame while its stiffness allows the catheter to be straightened as it is railed across the diamond.
If more selective engagement is necessary, a coronary wire can be used to enter the coronary artery ostium from a nearby position and a guide can be railed over it through the valve frame into the coronary.
  • If a J-wire fails, a stiff angled glide wire (Terumo Cardiovascular Systems, Elkton, MD) can be used to find the diamond in front of the ostia and the catheter can be railed over it for the engagement.
  • As it is more lubricious, it can more easily enter the diamond of the frame while its stiffness allows the catheter to be straightened as it is railed across the diamond.
If more selective engagement is necessary, a coronary wire can be used to enter the coronary artery ostium from a nearby position and a guide can be railed over it through the valve frame into the coronary.
If selective guide engagement continues to be an issue, a guide extension catheter can be railed into a coronary over a coronary wire with or without balloon-assisted tracking.
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ATHERECTOMY COMPLICATIONS

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