How to shorten a coronary guide catheter

Step-by-step description of how to shorten a coronary guide catheter using a 1 French smaller size sheath piece as connector

[@rshbarca3239]

Hello Dr Brilakis. Great fan of your channel and book. Do you know of any online e-learning / proctoring for coronary interventions particularly for devices use ? I have bumped into one like the CSI (cardiovascular systems inc.) for the diamondback orbital atherectomy, Im still waiting to hear back from them though. I was just wandering if such online learning even if only from close up step wise video presentations is available, for devices or techniques ? As you can imagine nowadays with the current situation, this would be helpful. Thank you

[@rakesht4548]

Hi Dr.. May i know why did you take such a risk for shortening the guide catheter..

[@manosbrilakis]

Guide shortening is done very infrequently at present because short guide catheters are commercially available. It may still need to be done mainly for retrograde crossing through long collateral channels or bypass grafts.

[@ahmedbadawy8048]

Dear Dr Birlakis, I think the torqueability of the catheter would be in question? did you find any problem with that issue ?

[@zfrost8431]

After cutting it is better to insert dilator into the lumen of the ends of the catheter too

[@shangz0216]

Thanks for your sharing

[@zfrost8431]

Good day! after cutting, it is better to insert the dilator into the lumen of the ends of the catheter

[@manosbrilakis]

Yes, it helps to make the lumen at the cutting point round.

[@ahmedsabbar9049]

Hi sir, I am from Iraq, I come across a case with sever folding of abdominal aorta, can we use the same method to elongate a catheter , thank u very much for sharring this intetesting case

[@manosbrilakis]

I have not it myself, but I am sure it could be done. I would be a little conscious with guide manipulations, however, so that the connected pieces do not come apart.

[@rengagovind727]

Sir, shall we use a normal guide inside a short guide as a mother in child?

[@assemherzallah4018]

Hi.. Is it safe enough.. I am afraid it may dislodge😥

[@juliansosa5545]

I thought exactly the same. Might be getting through a calcified and tortuous vessel(it has happened to me the ostium of the innominate artery) or the coronary Ballon in a chronic calcified plaque and when you push or retrieve the Ballon got recoil of the guide catheter. I would be scared of the catheter to got traped intravascular.

[@salahuddinsalahuddin3210]

In which case you would need a shorter guide catheter? Thanks

[@shahrukhbakar3248]

Retrograde CTO cases or for regular PCI when going down a long graft for a native vessel PCI that is too distal to reach since equipment can get ‘hubbed’ from inadequate reach.

[@rengagovind727]

Super sir