1. CATHETER
AND
GUIDWIRE
PRESENTER: DR. DHEERAJ KUMAR
MRIT, PH.D. (RADIOLOGYAND IMAGING)
ASSISTANT PROFESSOR
MEDICAL RADIOLOGYAND IMAGING TECHNOLOGY
SCHOOL OF HEALTH SCIENCES, CSJM UNIVERSITY, KANPUR
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Catheter and Giudewire By- Dr. Dheeraj Kuamr 1

2. CATHETER
HISTORY AND ORIGIN
 DEFINITION
 IDEAL CHARACTERISTICS
CLASSIFICATION
OTHER TYPE
 STERILIZATION
 MATERIALS
 MEASUREMENT
 MAIN TYPES
 USES
 REFERENCES
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3. HISTORY OF CATHETER
In 1929 werner forssmann demonstrated that a
Simple rubber catheter could be passed to the
Pulmonary artery through the anti-cubital
Vein and an angiographic film could be obtained
Using radiographic contrast.
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4. CATHETER
A catheter is a hollow flexible tube that can be inserted into a body
cavity, duct or vessel.
Catheters thereby allow drainage or injection of fluids , distend a
passageway or provide access by surgical instruments.
The process of inserting a catheter is catheterization.
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5. MATERIAL OF CATHETER IS MADE-UP OF
A range of polymers are used for the construction of catheters,
including silicone rubber latex and thermoplastic elastomers.
 Silicone is one of the most common choices because it is inert and
unreactive to body fluids and a range of medical fluids with which it
might come into contact.
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6. MATERIAL
Polyethylene (PE)
Fluoropolomers (PTFE) (TEFLON)
Polyurethane (PUR)
Silicone (SI)
Polyvinylchloride (PVC)
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7. IDEAL CONSTRICTION OF CATHETER
Better torque control
Strength
Radiopacity
Flexible
A traumatic tip
Low surface frictional resistance for good track ability over guide
wire.
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8. MEASUREMENT OF CATHETER
Joseph charrière (march 19, 1803 – april 28, 1876) was a swiss-born
french manufacturer of surgical instruments.
Joseph- frederic -benoît charrière
He invented the french gauge or the french scale for measuring the
diameter of A catheter .
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9. FRENCH CATHETER SCALE
The french catheter scale (most correctly abbreviated as F, but also often
abbreviated as FR or F) is commonly used to measure the outer diameter of
cylindrical medical instruments including catheters , needles etc.
In the french gauge system as it is also known, the diameter in millimetres of
the catheter can be determined by dividing the french size by 3, thus an
increasing french size corresponds with a larger diameter catheter. The
following equations summarize the relationships:
D(mm) = F/3 or F = d(mm)*3
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10. TYPES OF CATHETER
Diagnostic angiographic catheters.
Micro catheters.
Drainage catheters.
Balloon catheters.
Central venous catheters.
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11. DIAGNOSTIC CATHETER
• Cerebral catheters:
 Hinck-hilal ( head hunter ) catheter-used for $ vessel cerebral
angiogram. For more tortuous and elongated arch we use :
 bentson hanafee wilson (JB2, JB3)
 Simmons (SIM2) simmons catheter can also be used for selective
visceral angiography
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14. • Visceral catheters
Shepherd’s hook / hockey stick catheter.
Cobra head catheter.
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15. • Coronary catheters
Judkins catheters.
Amplatz catheters.
Sones coronary catheters.
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16. • Renal catheters selective catheters
Simmons or sidewinder catheters.
Rdc (renal double curved selective catheters)
Semi selective catheters has 6 side holes just proximal
to the tapered part.
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17. MICRO CATHETER
Designed for distal catheterization.
Placed over o.010 to 0.018 guide wire.
Used mostly for neuro-intervention
Helpful in peripheral intervention to select smaller
vessels for embolization.
 3 f or smaller.
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20. DRAINAGE CATHETER
• Used for drainage of fluid collection including
Nephrostomy
Abscess
Biliary gall bladder
Pleural fluid
Ascites
Lymphoceles.
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22. BALLOON ANGIOPLASTY CATHETER
• Either very soft and pliable as occlusion balloon or forgarty balloon to clear
thrombosis or can be rigid and used for dilatation ( ANGIOPLASTY ).
• Balloon for dilatation can be divided into 2 main categories regarding the size of
guide wire over which they are placed.
Porst mann’s korsetts balloon catheter
Dotter coaxial catheter
Caged balloon catheter
PVC balloon catheter
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25. CENTRAL VENOUS CATHETER
• There are three basic categories of catheters :
Non-tunnelled catheters – these catheters are placed via
central veins ( subclavian and internal jugular) by blinded
percutaneous technique.
Tunnelled catheters –they can be accessed externally and
are designed for long term home use.
Implanted subcutaneous port – these are attached to the
port that is buried subcutaneously for stabilization. They
maybe placed either on chest wall or the upper arm.
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26. OTHER CLASSIFICATION
• Catheters can be classified depending on
• Side holes : -:
Single hole
End hole with side holes.
Blocked end with side holes only.
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27. SIZE
• Abdominal – 6-80 cm
• Thoracic or carotid arteries – 100-120 cm
• NOTE: size depends on : > age of the patient > selective or
super selective study > size of the vessels.
• Note: ideal practice is to use the smallest diameter catheter
feasible for any particular study to minimize the risk of
arterial damage by the procedure.
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28. SHAPE
• Straight catheter
Pigtailed catheter ( for ventricles and arch of aorta )
Cobra shaped catheter
Side winder catheters (shepherd)
These four catheters are commonly used in the
radiology department .
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29. SOME OTHER TYPE OF CATHETER
• Hydrophilic catheters :
 hydrophilic-coated catheters have a layer of polymer coating
that is bound to the catheter surface. The polymer absorbs
and binds water to the catheter, resulting in a thick, smooth
and slippery surface.
Intermittent catheters: intermittent catheters are hollow
tubes used to drain urine from the bladder.
Paediatric catheters: usually its around 80cm.
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30. STERILIZATION OF CATHETER
• Methods for catheter sterilization :
The catheter is dried and then a plasma or gaseous sterilant
is used to sterilize at least the outer surfaces and the guide
wire lumen of the catheter.
Techniques for effectively sterilizing catheters, particularly
long-dwelling intravenous catheters includes
The transmission and dispersion of ultraviolet or infrared
radiation
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31. CONTENTS
DEFINITIONS
TYPES
TORQUE
LENGTH
SAFETY TEST
SELDINGER
 CONSTRICTION
 CORES
 TIP CONFIGURATIONS
 DIAMETER
 PRECAUTIONS
 TECHNIQUE
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32. GUIDWIRE
They are the stainless steel metallic structures that guides the
catheter through the blood vessels for placement. Guide wires are
used for both cardiology and radiology angiographic procedures.
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33. GUIDE WIRE
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34. • Guide wires are relatively simple spring type wires that
provides necessary firmness and the control to the site
where angiogram will be taken.
As the name suggests it ‘ guides’ the catheter.
Ptfe coated soft tip for the smoothness during the
insertion
Less trauma to the intimal wall of the artery
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35. CONSTRICTION OF GUIDWIRE
• They are made of stainless steel or other metallic alloys.
Alloys are formed when two or more metals are mixed
in a particular proportion to produce a single metallic
substance.
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36. TYPES OF GUIDWIRE
• They are two main types of guide wires :
 the solid guide wire
 Wrapped guide wire
• Both types of guide wire has one end that is rigid , with the
opposite end flexible. The flexible tip is introduced into the
blood vessel first, so that if the guide wire strikes a vessel
wall, it will bend, thereby preventing damage to the vessel.
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37. • The advantages of solid guide wires are that it reduces the
possibility of catheter tip flaring, blood clotting on the guide
wire, abrasion of the vessel and the danger of unravelling. The
one disadvantage of this type is its lack of versatility.
• The wrapped guide wire can be constructed so that it has a
movable core, making it more versatile than the solid stainless
steel guide wires, but it has other disadvantages:
 Possibility of catheter tip flaring.
 Blood clotting on the guide wire.
 Abrasion of the vessel.
 The danger of unravelling. 26-09-2023
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38. • To reduce the disadvantages of wrapped guide wire (
damage to the catheter or the vessels ) , the wrapping
maybe teflon coated or heparin-coated.
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39. CORES
• There are two main types of guide wire core :
Fixed cores ( for normal vascular system )
Movable cores ( for torturous vascular structures ) the
movable core has a handle MANDRIL
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40. TORQUE
• Refers to the response of the guide wire or the catheters
to movements ( like twisting, bending and turning )
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41. TIP CONFIGURATION
• There are two tip
configurations that
are available for guide
wires
The straight tip
The j-shaped tip
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42. LENGTH
• Guide wire length varies from 30 to 260 cm. The
shorter guide wires (30 to 50 cm ) are usually used for
percutaneous or direct vascular puncture. The average
guide wire employed for adults undergoing selective
angiography is approx. 100 to 150 cm in length. The
260 cm guide wires are used when interchanging
vascular catheters.
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43. DIAMETER
• The diameter of guide wire s are measured in fractions
of an inch, or millimetres. The range is 0.014” (0.35mm)
to 0.052” (1.32mm). The most common diameters used
for adults are 0.035” (0.089mm) and 0.038” (0.97mm).
There are several factors to consider when selecting the
proper diameter size.
• They are :
Needle gauge
Vessel size 26-09-2023
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44. SAFETY TEST
• Three test are performed to determine the safety of the
guide wire :
Determination of the flexibility of the guide wire tip by
bending the tip 180 degrees.
Visual inspection of wrapped guide wires junction of the
stiff core and the external coils at the distal tip.
 Checking of the core by giving a slight twist and tug to the
guide wire after the has passed these three safety tests, it
is ready for use.
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45. PRECAUTION
• Certain precautions must be taken when using a guide
wire. These precautions include –
Care when advancing the guide wire.
Position of the needle bevelled end .
Cleaning the guide wire.
Using a new guide wire.
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46. TECHNIQUE OF INSERTING CATHETER
• In 1953 , sven –ivor
seldinger invented
the technique of
gaining access
percutaneusly into an
artery without an
arteriotomy.
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47. SELDINGER TECHNIQUE
• The technique of catheter insertion via double-wall
needle puncture and guide-wire is known as the
SELDINGER TECHNIQUE.
• Double wall puncture: mostly done.
 Compression to prevent hematoma of the other wall.
 Rotatory movement to get the needle into the lumen.
• Single wall puncture: usually done for patients
coagulation time is less.
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49. PUNCTURE NEEDLE
• Used to cannulate or
puncture the artery.
• Usual sizes include 18 g, 19
g , 20g, 21 g.
• The selection of the size
depends on the guide wire
going to be inserted through
that needle port.
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