Current status of dilatation catheters and guiding systems.

New transluminal angioplasty catheters based upon the linear extrusion of the dilating element have been developed to facilitate placement of the dilating balloon within the arterial narrowing. In a multicenter study, the use of linear extrusion catheters has been shown to be safe and effective in adjunctive intraoperative peripheral dilatations. Physical measurements of the frictional forces exerted on the inner arterial surfaces during advancement of 3 angioplasty catheter designs show that the linear extrusion catheter consistently minimizes these forces. The use of a secondary guiding sheath in conjunction with a linear extrusion catheter provides additional directional capability. A secondary guiding sheath with a side port has recently been developed that allows access to difficult-to-cannulate vessels. The favorable results of the clinical studies and research data justify an ongoing evaluation of these concepts in percutaneous dilatation procedures and in intraoperative coronary procedures.