PCI equipment: guiding catheter selection
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Percutaneous coronary intervention Microchapters |
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PCI Complications |
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PCI in Specific Patients |
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PCI in Specific Lesion Types |
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Editors-In-Chief: Alexandra Almonacid M.D.; Jeffrey J.Popma M.D. Associate Editor(s)-in-Chief: Muhammad Saad, M.B.B.S.[1]
Overview
Diagnostic catheters used for coronary arteriography are usually constructed from polyethylene or polyurethane with a fine wire braid within the wall to allow advancement and directional control (torquability) and to prevent kinking. The outer diameter size of the catheters ranges from 4 to 8F, but 5 and 6F catheters are used most commonly for diagnostic arteriography. Guiding catheters for percutaneous coronary intervention (PCI) differ from diagnostic catheters in that they have larger internal lumens, stiffer shafts for backup support, and atraumatic soft tips to minimize coronary artery injury. Selection of the appropriate guiding catheter is a critical determinant of procedural success, as it must provide coaxial alignment with the coronary ostium, adequate backup support for device delivery, and sufficient internal diameter for the planned interventional equipment.
Guiding Catheter Selection
General Principles
Guiding catheter selection should balance the feasibility of engaging the coronary artery with adequate support to complete the procedure.[1] Two types of backup support are recognized:
Passive support: The catheter body rests against the contralateral aortic wall (e.g., EBU/XB catheters seated in the contralateral sinus of Valsalva for left coronary artery PCI), providing support without active operator manipulation.[1]
Active support: Operator-applied torque and push to increase engagement force (e.g., deep-seating of the guide catheter into the coronary artery).[1]
Dedicated transradial access (TRA) guide catheters (Ikari left, MAC, Kimny) provide the option of passive or active support depending on the technique of engagement.[1]
Guiding Catheter Size
The majority of PCIs — including treatment of complex bifurcation lesions, use of covered stents, and aspiration devices — can be performed via 6F guide catheters.[1] A prospective, multicenter, randomized trial of 460 patients demonstrated that 6F guides had similar angioplasty success rates to 7F/8F guides (87% vs. 88%) with significantly fewer femoral complications (13.8% vs. 23.5%; P<0.01), less contrast use (136±68 vs. 168±95 mL; P<0.0001), and shorter procedural time (36±22 vs. 41±28 min; P<0.01).[2]
Larger guide catheters are required for specific situations:[1]
Use of an aspiration device with two 0.014-inch wires in the coronary artery
Rotational atherectomy burrs >1.75 mm
Simultaneous deployment of 2 stents
For larger guides via radial access, sheathless guide techniques or thin-walled 7-in-6F sheaths may be used.[1]
Guiding Catheter Size Requirements by Procedure Type
| Procedure / Device | Minimum Guide Catheter Size | Notes |
|---|---|---|
| Standard PCI (single stent, single balloon) | 6F | Sufficient for the majority of PCI procedures |
| Rotational atherectomy burr 1.25–1.5 mm | 6F | Standard 6F inner diameter adequate |
| Rotational atherectomy burr 1.75 mm | Large 6F (0.071-inch ID) or 7F | Requires larger inner diameter than standard 6F |
| Rotational atherectomy burr 2.0 mm | Large 7F (0.081-inch ID) or 8F | — |
| Rotational atherectomy burr 2.15 mm | 8F | — |
| Bifurcation PCI: provisional stenting, T-stent, reverse crush, step crush | 6F | Second stent advanced after first is positioned |
| Bifurcation PCI: standard crush, V/simultaneous kissing stents | ≥7F (0.081-inch ID) or ≥8F (0.088-inch ID) | Depends on stent platform |
| Bifurcation PCI: modified T technique | ≥7F | — |
| Bifurcation PCI: culottes, Y, skirt techniques | ≥8F | — |
| Chronic total occlusion PCI | 7F–8F preferred | 8F recommended for complex cases; 7F adequate for most contemporary techniques |
| Left main PCI (standard) | 6F (EBU 3.5/3.75 or JL 3.5/4.0) | Side holes recommended if left main ostium is diseased |
| Left main PCI (complex: large arteries, RA burr >1.75 mm, simultaneous 2-stent delivery) | 7F or 8F | — |
Sources: SCAI Expert Consensus Statement on Calcified Coronary Lesions (2024)[3]; Iakovou et al., JACC (2005)[4]; Rab et al., JACC Cardiovasc Interv (2017)[5]
Judkins Catheters
The left Judkins catheter has been developed to allow entry into the left coronary ostium from the femoral approach with minimal catheter manipulation. A preformed left Judkins catheter can also be used from the left brachial or radial artery, but a catheter with 0.5 cm less curvature than required for the femoral approach is generally better suited for coronary cannulation. The right Judkins catheter is shaped to permit entry into the right coronary artery (RCA) with a small amount of rotational (clockwise) catheter manipulation from any vascular approach.
Selection of Judkins catheter shape is based on the body habitus of the patient and size of the aortic root. The left coronary artery (LCA) is easily engaged with the Judkins left 4.0 catheter from the femoral approach in most patients, whereas patients with a dilated ascending aorta (e.g., in the setting of congenital aortic stenosis and post-stenotic dilation) may require the use of a Judkins left 5.0 or 6.0 catheter.
Patients with large ascending aortic aneurysms may require arteriography with heat-modified catheters to achieve Judkins left 7.0 to 10.0 shapes. Use of a Judkins shape that is too small for the ascending aorta often leads to folding of the catheter within the aortic root. The best technique for removing a folded Judkins left catheter from the body involves withdrawing the folded catheter into the descending aorta and advancing a guidewire anterograde in the contralateral common iliac artery. On withdrawal of the catheter and guidewire together, the catheter straightens and can be removed safely from the body without disrupting the arterial access site.
For diagnostic coronary angiography, an international survey of 987 operators across 6 continents found that Judkins left 4.0 was the most commonly used catheter for LCA angiography (77%) and Judkins right 4.0 for RCA angiography (73%).[6] For interventional procedures, XB 3.5 (29%) and EBU 3.5 (25%) were the most preferred guide catheters for LAD and LCx PCI, while the Judkins right guide catheter was preferred by 86% of operators for RCA PCI.[6]
Amplatz Catheters
Amplatz catheters can be used for the femoral or brachial approach to coronary arteriography. The Amplatz catheters are an excellent alternative in cases in which the Judkins catheter is not appropriately shaped to enter the coronary arteries. The Amplatz L-1 or L-2 catheter may be used for coronary angiography from the right brachial or radial approach and can provide excellent passive backup support for more complex interventions.[1] A modified right Amplatz catheter (AR-1 or AR-2) can be used for engagement of a horizontal or upward takeoff RCA or SVG.
Extra Backup (EBU/XB) Catheters
For left coronary artery PCI, most operators prefer extra backup single-curve guide catheters (e.g., EBU, XB, Voda).[1][6] These catheters offer passive backup support from the contralateral sinus of Valsalva and provide deep-seating capability. Smaller curves tend to point upward and preferentially engage the LAD, while larger curves direct downward to better engage the circumflex.[1]
Dedicated Transradial Access (TRA) Catheters
Although a multiple-catheter strategy using Judkins-shaped catheters is preferred among the majority of operators (JR 4.0 for RCA, JL 3.5 for LCA if right radial, JL 4.0 for LCA if left radial), dedicated TRA catheters (e.g., Kimny, Tiger, Jacky, DxTerity, Ultimate) allow a single catheter to be used to engage either coronary ostium.[1]
For primary PCI in STEMI, the single-guide catheter technique with an extra backup (3.5 or 3.75) or dedicated TRA guide catheters (Ikari left, MAC, Kimny) can engage either the right or left coronary artery and provide the option of passive or active support, depending on the technique of engagement.[1]
Other Catheters
Other catheters used for coronary arteriography include the left IMA catheter with an angulated tip that allows engagement of the IMA or an upward takeoff RCA. Catheter shapes that permit engagement of SVGs include the multipurpose catheter, right Judkins, modified right Amplatz, and hockey stick catheters. Specially designed catheters for engagement of the coronary arteries from the radial artery have also been developed.
Catheter Selection by Target Vessel
Left Coronary Artery System
| Clinical Scenario | Preferred Guide Catheter(s) | Alternative(s) |
|---|---|---|
| Standard LAD/LCx PCI | EBU 3.5/3.75, XB 3.5 | Amplatz left 1 or 2; Voda |
| Left main PCI (standard) | EBU 3.5/3.75 or JL 3.5/4.0 (with side holes if ostium diseased) | — |
| Left main PCI (complex: large arteries, RA burr >1.75 mm, 2-stent delivery) | 7F or 8F EBU or JL | — |
| Transradial LCA PCI | EBU 3.5/3.75, XB 3.5 | Ikari left, MAC, Kimny (single-catheter technique) |
| Primary PCI (STEMI) | EBU 3.5/3.75 (single-catheter technique) | Ikari left, MAC, Kimny |
Sources: AHA Scientific Statement (2018)[1]; Damluji et al. (2017)[6]; Rab et al. (2017)[5]
Right Coronary Artery System
The right coronary artery takeoff varies considerably more than the left coronary artery, necessitating a broader range of catheter shapes to accommodate anatomical differences.
| RCA Takeoff / Anatomy | Preferred Guide Catheter(s) | Alternative(s) |
|---|---|---|
| Horizontal (standard) | JR 4.0 | — |
| Superior takeoff | JR, Hockey Stick, Amplatz left | Kiesz Right Superior |
| Inferior takeoff | Multipurpose | — |
| Dilated aortic root / shepherd's crook origin | Amplatz left (0.75 or 1), MAC (3.0 or 4.0) | XB-RCA, Ikari left (3.5 or 4.0) |
| Anterior origin | Amplatz left (0.75 or 1) | MAC, XB-RCA |
Sources: AHA Scientific Statement (2018)[1]; Damluji et al. (2017)[6]
Saphenous Vein Grafts
| Graft Target | Preferred Guide Catheter(s) | Notes |
|---|---|---|
| SVG to RCA | Multipurpose | Shape of choice via radial or femoral; JR rarely effective for vertical grafts; AL1/AL2 may require more manipulation |
| SVG to LCx/diagonal | JR catheter or AL1/AL2 | High and posterior takeoff can be challenging and may require large Amplatz guide |
| LIMA to LAD | Classic IMA catheter | Left radial access preferred; extreme subclavian tortuosities can make selective cannulation problematic |
Globally, the JR4 catheter is the most commonly used for both left and right SVG PCI. However, in North America, operators prefer the Amplatz left catheter for left SVGs (37%) and the multipurpose catheter for right SVGs (43%).[6]
Sources: Damluji et al. (2017)[6]
Anomalous Coronary Arteries
Engagement of anomalous coronary arteries requires careful preprocedural planning. A deep aortic root angiogram in anteroposterior (AP) and lateral projections is recommended first to identify the origin before catheter selection.[7]
| Anomalous Origin | Preferred Guide Catheter(s) | Notes |
|---|---|---|
| Anomalous RCA from left cusp (adjacent to LM) | Leya catheter (Amplatz left 90°), R-ACAOS Launcher guide (6F), EBU catheter | Most technically challenging; EBU achieved 100% success in Type A (above LCA) and 83.3% in Type B (below LCA) |
| Anomalous RCA from left cusp (inferior to LM or toward commissure) | Amplatz left 1, 2, or 3; Amplatz right 1, 2, or 3 | Size selection based on aortic root dimensions |
| Anomalous RCA from commissure or ascending aorta | JR4, Hockey Stick, Multipurpose, Amplatz left/right | — |
| When selective engagement cannot be achieved | Guide extension catheter (GuideLiner) advanced over coronary guidewire | Provides selective engagement when standard catheters fail |
Sources: Ben-Dor et al., JACC Cardiovasc Interv (2021)[7]; Gebremedhin et al., PLoS One (2025)[8]
Vascular Access and Catheter Selection
The 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for ACS recommends a radial approach (Class 1, Level of Evidence A) for patients with acute coronary syndrome undergoing PCI to reduce bleeding, vascular complications, and death.[9] The 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization similarly endorses radial access as Class 1, Level of Evidence A for both ACS and stable ischemic heart disease PCI.[10]
The SCAI Expert Consensus Update on Best Practices in the Cardiac Catheterization Laboratory (2021) recommends that all operators develop and maintain competency in both radial and femoral arterial vascular access, and that vascular ultrasound should be available for universal use.[11] The choice of right versus left radial access depends on patient age and height (higher incidence of right subclavian tortuosity in older and shorter patients), presence of hemodialysis fistula grafts, presence of internal mammary artery bypass grafting (favor ipsilateral radial access), and prior procedural difficulty.[11]
Transfemoral access should be considered when temporary mechanical circulatory support is planned and is the default alternative access site when the radial artery cannot be used.[9]
Inadequate support accounts for 7% to 17% of transradial PCI failures, but this becomes less relevant as operator experience increases.[1]
Catheter Selection for Specific Complex PCI Scenarios
Chronic Total Occlusion PCI
Access site selection is critical in chronic total occlusion (CTO) PCI for providing appropriate support and allowing simultaneous use of multiple devices. Many operators recommend 8F guiding catheters, mostly via transfemoral access, for CTO PCI.[12] Currently, most CTO techniques — including antegrade dissection and re-entry with the Stingray LP system and simultaneous IVUS-controlled cap puncture — can be performed with 7F guide catheters using 7F-compatible equipment combinations (e.g., 5F IVUS and low-profile microcatheters).[13] Eight-French guide catheters are still needed for more complex antegrade IVUS-controlled re-entry cases and for ipsilateral single-guide retrograde cases with simultaneous IVUS guidance.[13]
Biradial CTO PCI is increasingly performed using 7F slender sheaths or sheathless 8F transradial guides. However, complex cases (J-CTO score ≥3) performed via transradial access had significantly lower technical success than transfemoral (35.7% vs. 58.2%; P=0.004).[12]
Dual arterial access is commonly used (bifemoral, biradial, femoral-radial) for contralateral injection, which is critical for CTO PCI and should be performed in every case where contralateral collaterals exist.[14]
Left Main PCI
Left main PCI can be performed via femoral or radial access with 6F EBU 3.5/3.75 or JL 3.5/4.0 guiding catheters (with side holes if the left main ostium is diseased).[5] Routine intravascular imaging is recommended for left main PCI.[15] For complex left main bifurcation lesions (Medina 1,1,1 or 0,1,1 with side branch lesion ≥70% and length ≥10 mm), an upfront DK crush (preferred) or other two-stent technique is recommended, which may necessitate ≥7F guide catheters to accommodate simultaneous stent delivery.[15][5] Ad hoc unprotected left main PCI is discouraged.[15]
Guide Catheter Extensions
Guide catheter extensions (GCEs) are coaxial catheters that are advanced through the guiding catheter and into the coronary artery to provide additional backup support and facilitate device delivery. They have become indispensable for contemporary complex PCI, particularly chronic total occlusion PCI.[16]
Available Devices
Currently available GCE devices include:[16]
GuideLiner V3 (Teleflex)
TrapLiner (Teleflex)
Guidezilla II (Boston Scientific)
Telescope (Medtronic)
Guidion (IMDS)
Expressman (ATP Medical)
Boosting Catheter (QX Medical)
LiquID (Seigla Medical)
Key Applications
Increasing backup support for wire crossing in CTO PCI and heavily calcified lesions[16]
Facilitating balloon/stent delivery in uncrossable lesions where standard guide catheter support is insufficient[16]
"Reach and capture" of retrograde microcatheter during retrograde CTO PCI[16]
Selective engagement of anomalous coronary arteries when standard catheters fail[7]
Advancing Techniques
The preferred contemporary approach for advancing GCEs is the "inchworming" technique, in which the GCE and guidewire/balloon are alternately advanced in small increments. Other techniques include distal anchoring (inflating a balloon distally to provide a rail for GCE advancement) and balloon tracking (advancing the GCE over an inflated balloon).[16]
Clinical Evidence
A study of 188 patients in whom the Guidezilla catheter was used (most commonly for CTOs [45%] and heavy proximal calcification [37%]) demonstrated target lesion crossing success and procedural success rates of 99%, with one device-related complication (proximal vessel dissection from deep insertion, treated with stent). Ninety percent of procedures were completed via radial access.[17]
A series of 54 patients using the GuideLiner for complex PCI (CTO [39%], anomalous/angulated takeoff [31%], previously deployed proximal stents [15%], heavy calcification [9%], tortuosity [7%]) showed a procedural success rate of 98% with no device-related periprocedural complications.[18]
Complications of Guiding Catheter Use
Major PCI complications occur in 0.2% to 3.2% of cases (higher in AMI and high-risk PCI).[19] Catheter-related complications include:
Coronary artery dissection: Can result from aggressive catheter engagement, deep-seating, or forceful contrast injection. Management includes confirming intraluminal guidewire position, brief balloon inflations, and stenting.[20]
Coronary perforation: May occur with deep-seating of guide catheters or guide extensions, particularly in tortuous or calcified vessels.[20]
Air embolism: Can result from inadequate flushing of the guide catheter or guide extension system.[20]
Abrupt vessel closure (AVC): Incidence has decreased from approximately 3% in the plain old balloon angioplasty (POBA) era to approximately 0.3% with contemporary techniques. Mechanisms include dissection, intracoronary thrombus, native thrombus/atheroma embolization, air injection, and spasm.[20]
Vascular access complications: Ischemic limbs, retroperitoneal bleeding, AV fistulas, pseudoaneurysms, and expanding hematomas — significantly lower with radial access compared with femoral access.[19]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 Mason PJ, Shah B, Tamis-Holland JE, Bittl JA, Cohen MG, Safirstein JG, Doshi D, Parise H, Bhatt DL, Stone GW (2018). "An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome: A Scientific Statement From the American Heart Association". Circ Cardiovasc Interv. 11 (9): e000035. doi:10.1161/HCV.0000000000000035. PMID 30354567.
- ↑ Metz D, Meyer P, Touati C, Radoux H, Steg PG, Puel J, Danchin N (1997). "Comparison of 6F with 7F and 8F guiding catheters for elective coronary angioplasty: results of a prospective, multicenter, randomized trial". Am Heart J. 134 (1): 131–137. PMID 9266794.
- ↑ Riley RF, Patel MP, Abbott JD, Brilakis ES, Croce KJ, Danek BA, Doshi D, Grantham JA, Kirtane AJ, Mahmud E, Maini B, Moses JW, Parikh SA, Pershad A, Rangan BV, Sharma SK, Shlofmitz RA, Truesdell AG, Waksman R, Weisz G (2024). "SCAI Expert Consensus Statement on the Management of Calcified Coronary Lesions". J Soc Cardiovasc Angiogr Interv. 3 (2): 101259.
- ↑ Iakovou I, Ge L, Colombo A (2005). "Contemporary stent treatment of coronary bifurcations". J Am Coll Cardiol. 46 (8): 1446–1455. PMID 16226168.
- ↑ 5.0 5.1 5.2 5.3 Rab T, Sheiban I, Louvard Y, Sawaya FJ, Zhang JJ, Chen SL (2017). "Current Interventions for the Left Main Bifurcation". JACC Cardiovasc Interv. 10 (9): 849–865. PMID 28473106.
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 Damluji AA, Nelson DW, Valgimigli M, Spertus JA, Bavry AA, Batchelor WB, Wasfy JH, Arora S, Huang C, Resar JR (2017). "Transfemoral Approach for Coronary Angiography and Intervention: A Collaboration of International Cardiovascular Societies". JACC Cardiovasc Interv. 10 (22): 2233–2241. PMID 29169494.
- ↑ 7.0 7.1 7.2 Ben-Dor I, Weissman G, Rogers T, Shults C, Chen Y, Waksman R (2021). "Catheter Selection and Angiographic Views for Anomalous Coronary Arteries: A Practical Guide". JACC Cardiovasc Interv. 14 (9): 901–916. PMID 33865754 Check
|pmid=value (help). - ↑ Gebremedhin ML, Sigdel M, Ruixue Z, Du B, Zhang Y (2025). "What Role Should EBU Catheters Play in the Interventional Approach to Anomalous Right Coronary Arteries? A Case Series". PLoS One. PMID 41468450 Check
|pmid=value (help). - ↑ 9.0 9.1 Rao SV, O'Donoghue ML, Ruel M, Bhatt DL, Cannon CP, de Winter RJ, "; Harrington RA, Hess CN, Kirtane AJ, Mehran R, Morrow DA, Tamis-Holland JE (2025). "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes". J Am Coll Cardiol. Vancouver style error: punctuation (help)
- ↑ Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA (2022). "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization". J Am Coll Cardiol. 79 (2): e21–e129. PMID 34882435 Check
|pmid=value (help). - ↑ 11.0 11.1 Naidu SS, Abbott JD, Bagai J, Bates ER, Brilakis ES, Bhatt DL, Dehmer GJ, Feldman DN, Jolly SS, Kern MJ, Klein LW, Kumbhani DJ, Mahmud E, Rao SV, Swaminathan RV, Trost JC (2021). "SCAI Expert Consensus Update on Best Practices in the Cardiac Catheterization Laboratory". Catheter Cardiovasc Interv. 98 (2): 255–276. PMID 33939260 Check
|pmid=value (help). - ↑ 12.0 12.1 Tajti P, Burke MN, Karmpaliotis D, Brilakis ES (2018). "Update in the Percutaneous Management of Coronary Chronic Total Occlusions". JACC Cardiovasc Interv. 11 (7): 615–625. PMID 29622147.
- ↑ 13.0 13.1 Wu EB, Brilakis ES, Mashayekhi K, Tsuchikane E, Alaswad K, Araya M, Avran A, Azzalini L, Babunashvili AM, Bayani B, Bhatt H, Boudou N, Brilakis ES, Buller CE, Burke MN, Carlino M, Collet C, Dashkoff N, Dautov R, Egred M, Elbarouni B, Fam JM, Gao L, Goktekin O, Grancini L, Grantham JA, Hanratty CG, Harding SA, Henriques J, Hill JM, Jaffer FA, Jia H, Joyal D, Karmpaliotis D, Kashima Y, Kedev S, Knaapen P, Krestyaninov O, Lee SW, Mashayekhi K, Moliterno DJ, Nicholson WJ, Ojeda S, Opolski MP, Patel M, Pershad A, Rangan BV, Rinfret S, Romaguera R, Saito S, Sapontis J, Sianos G, Smith EJ, Spratt JC, Stubbs P, Surmely JF, Suzuki M, Takahashi S, Tanabe G, Tanaka H, Thompson CA, Tsuchikane E, Uretsky BF, Van den Branden B, Walsh SJ, Werner GS, Wyman RM, Yeh RW, Yokoi H, Zhao Y (2021). "Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review". J Am Coll Cardiol. 78 (8): 840–853. Vancouver style error: initials (help)
- ↑ Brilakis ES, Mashayekhi K, Tsuchikane E, Alaswad K, Araya M, Avran A, Azzalini L, Babunashvili AM, Bayani B, Bhatt H, Boudou N, Brilakis ES, Buller CE, Burke MN, Carlino M, Collet C, Dashkoff N, Dautov R, Egred M, Elbarouni B, Fam JM, Gao L, Goktekin O, Grancini L, Grantham JA, Hanratty CG, Harding SA, Henriques J, Hill JM, Jaffer FA, Jia H, Joyal D, Karmpaliotis D, Kashima Y, Kedev S, Knaapen P, Krestyaninov O, Lee SW (2019). "Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention". Circulation. 140 (5): 420–432. PMID 31356129. Vancouver style error: initials (help)
- ↑ 15.0 15.1 15.2 Riley RF, Henry TD, Mahmud E, Kirtane AJ, Brilakis ES, Pershad A, Grantham JA, Sandoval Y, Garberich RF, Shunk KA, Shlofmitz RA, Maini B, Kiesz RS, Doshi D, Truesdell AG, Weisz G, Moses JW (2020). "SCAI Position Statement on Optimal Percutaneous Coronary Interventional Therapy for Complex Coronary Artery Disease". Catheter Cardiovasc Interv. 96 (4): E349–E378. PMID 31868311.
- ↑ 16.0 16.1 16.2 16.3 16.4 16.5 Garbo R, Iannaccone M, Werner GS, Sianos G, Brilakis ES, Mashayekhi K, Carlino M, Tsuchikane E, Avran A, Azzalini L, Bufe A, Buller CE, Burke MN, Dautov R, Galassi AR, Goktekin O, Hanratty CG, Hill JM, Joyal D, Karmpaliotis D, Krestyaninov O, Nicholson WJ, Ojeda S, Opolski MP, Rinfret S, Romaguera R, Saito S, Spratt JC, Surmely JF, Walsh SJ, Wyman RM, Brilakis ES (2023). "Utility of Guiding Catheter Extensions for Recanalization of Chronic Total Occlusions: A EuroCTO Club Expert Panel Report". JACC Cardiovasc Interv. 16 (15): 1813–1826. PMID 37558296 Check
|pmid=value (help). - ↑ Ma J, Hou L, Qian J, Ge J (2017). "The safety and feasibility of Guidezilla catheter in complex coronary interventions and an observational study". Medicine (Baltimore). 96 (40): e8177. PMID 28984768.
- ↑ Chan PH, Alegria-Barrero E, Foin N, Sandhu SK, Di Mario C (2015). "Extended use of the GuideLiner in complex coronary interventions". EuroIntervention. 11 (3): e1–e4. PMID 24930135.
- ↑ 19.0 19.1 Bass TA, Abbott JD, Mahmud E, Giri J, Swaminathan RV, Blankenship JC, Kern MJ, Naidu SS, Brilakis ES, Chambers CE, Dehmer GJ, Feldman DN, Kirtane AJ, Klein LW, Rao SV, Tamis-Holland JE, Trost JC (2023). "2023 ACC/AHA/SCAI Advanced Training Statement on Interventional Cardiology (Coronary, Peripheral Vascular, and Structural Heart Interventions)". J Am Coll Cardiol. 81 (24): 2374–2413. PMID 37100546 Check
|pmid=value (help). - ↑ 20.0 20.1 20.2 20.3 Giannini F, Candilio L, Mitomo S, Ruparelia N, Chieffo A, Baldetti L, Ponticelli F, Latib A, Colombo A (2018). "A Practical Approach to the Management of Complications During Percutaneous Coronary Intervention". JACC Cardiovasc Interv. 11 (18): 1797–1810. PMID 30236354.