SAFETY GUIDESPRING FOR PERCUTANEOUS CARDIOVASCULAR CATHETERIZATION

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Abstract
1. Guide spring breakage can be lessened by several means: (1) the proper choice of spring wire, (2) avoidance of chemical weakening (as by acid core solder or electroplating), (3) pre-use testing, (4) in-use avoidance of overflexion, and (5) minimum re-use of spring guides. Attention to the foregoing will minimize but not prevent the breakage of catheter guides. 2. The clinical importance of guide breakage can be reduced markedly by the use of a slender, separate guard-wire which, together with the usual fixed or movable central stiffening wire, runs through the center of the guide and which, through attachment to the extreme tip of the guide, prevents separation in the event of spring breakage. The integrity and attachment of this inner guard wire can readily be tested (by attempting to stretch the spring) and its fracture at the time of spring breakage appears to be an extremely unlikely event in the hands of the alert and competent worker. This new safeguarded catheter guide is commercially available at a cost which permits it to be used as an expendable item. 3. Guide tip configuration can be externally controlled by shortening so as to "stack" coils and thereby straighten the axis of a pre-curved guide spring. This approach requires the use of an inner wire attached to the tip of the catheter which would interfere with tip flexibility were the ordinary core wire to be used for this purpose. The safety guide reported here offers means for increasing safety and control without greatly increasing the cost of guided catheterization.

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