Vascular Reconstructions by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9781071610893
Publisher: Springer New York

Sheaths and Guiding Catheters

Sheaths

A sheath is the outermost component of the endovascular platform. It is used to secure the arterial access site and provide a passage for the wires, catheters, and all other devices. Sheaths provide a path for contrast media injection while wires and sometimes other devices remain in place. They also provide a stable platform for the passage of devices through tortuous vessels or tight lesions.

Sheath size is the diameter of its inner lumen in French, which determines the size of the catheters or other devices that can be used. The sizes are color-coded. For example, a 4 Fr sheath is red; 9 Fr or larger is black (Fig. 21.5). Sheaths have integrated dilators with tapered tips that allow the dilation of the soft tissue track and the arterial puncture site and sometimes pre-dilate distal stenotic vessels to allow for safe insertion stenotic vessels to allow for safe insertion of the sheath. They have a one-way hemostatic valve to allow the insertion of wire and devices while preventing back bleeding. They also have a side port that allows for blood draws and injection of contrast. Some sheaths (such as BRITE TIP® interventional sheath, Cordis) have a radiopaque marking at the tip to facilitate accurate positioning of the sheath’s end (Fig. 21.6).

Fig. 21.5Sheath sizes are color-coded (left to right): red, 4 Fr; grey, 5 Fr; green, 6 Fr; orange, 7 Fr

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