ABSTRACT
The guidewire–catheter combination is the endovascular workhorse. The operator must decide what guidewire–catheter combination should be used in any given case and decide how to get the selected combination into the position required. Guidewires and catheters have become familiar tools, and the next step is guidewire and catheter passage to the desired location. Bony landmarks or other anatomic signs are usually adequate to establish the correct location for catheter head placement. Fluoroscopy is initiated again when the catheter is in the artery. The progress of the catheter is monitored using fluoroscopy until it is in the desired location. A catheter may add stiffness, steering, and pushing strength to a guidewire. Occasionally, arteries may be so diffusely diseased that there is no approach through relatively healthy segments for arteriographic catheter placement. A very remote puncture site may be required in a variety of circumstances and the tools are generally available for most of these occasions.
