**Table 11.**

*Coronary Embolectomy Catheters.*

interventions (**Table 11**). They share the same principle of mechanical aspiration embolectomy that depends on manual or machine assisted aspiration of the clot. Multiple passes might be required for some cases. No blood return while aspirating is a sign of either poor flow triggered by clot occluding the catheter or suctioning against the vessel wall. When no blood return is seen, the catheter should be withdrawn till blood return is seen. If blood return still not seen, the catheter should be removed out of the body and examined for clot at the tip. It is very important to keep negative pressure while withdrawing the catheter out of the GC followed by

*Cardiac Diseases - Novel Aspects of Cardiac Risk, Cardiorenal Pathology and Cardiac Interventions*

Aspiration thrombectomy can aspirate the clots from the coronaries and displace it to systemic circulation. The data of using aspiration embolectomy is controversial. Most recent guidelines recommend against their routine use due to increased risk of embolic strokes and no clinical outcome benefit. However, some cases with signif-

Upsizing or exchanging GC to provide more support during procedure is challenging after crossing a difficult lesion or any case where guide wire position is critical. The risk of losing guide wire position while loading the new GC is high. Long guide wire or adding extension wire is first step. More support with additional buddy wire and/or using micro catheter inside the new GC could be helpful.

bleed back of the GC to remove any potential clot left within the GC.

Coronary micro-catheters are small catheters compatible with 0.014″ coronary wires. There is a wide spectrum of micro-catheters with different designs (**Table 12**). They provide operators with significant ability to provide wire exchanges, crossing difficult lesions, assist wiring difficult angulated lesions (**Table 13**) and many other technical advantages especially in CTO

**Manufacturer Catheter name Compatibility Length Note**

Export AP 6.0 Fr 140 cm

Fetch 2 6Fr 135 cm

Pronto 5.0 to 10 Fr Pronto V4 (138 cm)

Pronto V3 (140 cm) Pronto LP (138 cm)

Medtronic Export Advance 6.0 Fr 140 cm

Terumo Priority one 6 and 7FR 140 cm Spectranetics Quick Cat 6Fr 145 cm Atrium Xpress-Way 6 and 7 Fr 140 cm

Stron Medical Vmax 5, 6 and 7Fr 135–141 cm Tsuna Med Emax 5, 6 and 7Fr 136.5–141 cm

Pneumbra Indigo CAT RX 5.3 Fr 140 cm Aspiration catheter of

CAT RX SEPC4 catheter can be used to break the clots (200 cm)

Pronto V4 and V3 are available with 5.5, 6, and 8Fr Pronto LP available with 5, 6 Fr Pronto 0.03 is peripheral catheter 10 Fr, 120° angled 4 cm tip

icant thrombosis cannot be resolved without their use.

interventions.

Vascular solutions/ Teleflex

Boston Scientific

**Table 11.**

**220**

*Coronary Embolectomy Catheters.*


#### **Table 12.**

*Coronary micro catheters.*
