ABSTRACT
Small platform guidewires with a 0.014-inch diameter were developed to manage the smaller diameter arteries of the coronary vasculature. Small caliber systems may be passed over the full length of the catheter or they may be used with a monorail system. During a therapeutic procedure, such as balloon angioplasty or stenting, the position of the sheath tip need not be close to the target lesion for treatment because the coaxial nature of the guidewire is usually sufficient to maintain stability. The monorail system gives the operator more control over the guidewire and makes it stable. The monorail system has less friction, so the pushability of the catheters is faster and smoother. Subclavian stents provide a similar challenge: stability of the platform versus maneuverability of treatment devices. The “no touch” technique becomes possible with smaller caliber systems, but the stability of the treatment platform may be questionable when it is across a severe angle to enter the vessel.
