Terumo Hiryu Manual Del Usuario página 23

5-3 If the improvement of the stenosis is not sufficient, increase the inflation pressure of the balloon
gradually to the RBP, or pressurize it repeatedly until no further improvement can be attained.
Usually, repeated inflation of the balloon brings about sufficient improvement of the stenosis,
which can be confirmed by coronary angiography.
6. Exchange of the dilatation catheter
6-1 Loosen the hemostatic valve of the Y connector.
6-2 Grasp the guide wire and the hemostatic valve in one hand and the catheter in the other.
6-3 Remove the dilatation catheter while maintaining the position of the guide wire in the lesion. Wipe
the guide wire surface to avoid problems when inserted in the next catheter.
WARNING
CAUTION
6-4 Insert the next catheter over the proximal end of the guide wire as previously described while
maintaining the guide wire position.
CAUTION
6-5 Follow the directions for use labelled "Insertion of the dilatation catheter" after 4-7 and inflate/
exchange dilatation catheters.
∗ 7. Removal of the dilatation catheter
After completion of dilatation, deflate the balloon completely and remove the dilatation catheter
and guide wire after loosening the hemostatic valve. It is recommended to keep the guide wire in
position for a while after the procedure, preparing for any possible unexpected incidents. In order to
dispose of the removed dilatation catheter safely and properly, use CATHETERCLIP in accordance
with "Directions for use of CATHETERCLIP and balloon protection sheath".
∗ 8. Directions for use of CATHETERCLIP and balloon protection sheath
8-1 Directions for use of CATHETERCLIP
1. Remove the CATHETERCLIP from its holder.
2. Shape PTCA dilatation catheter into a single or double loop (Fig. 1).
CAUTION
3. Secure the coiled PTCA dilatation catheter with the CATHETERCLIP following the steps
below:
• Hook the tip of the CATHETERCLIP onto the PTCA dilatation catheter (Fig. 2).
• Fix the PTCA dilatation catheter onto the other end of the CATHETERCLIP (Fig. 3).
WARNING
4. When removing the CATHETERCLIP from the coiled PTCA dilatation catheter, repeat above
steps in reverse (Fig. 3 to Fig. 2).
CAUTION
8-2 Directions for use of balloon protection sheath
CAUTION
∗
• While the guide wire is in the vessel, remove the catheter in a straight line
along the guide wire.
• Do not remove the catheter if it is bent at the Y connector port. If removal of
a bent catheter is attempted, excessive pressure is applied to the area near
the guide-wire port, possibly damaging or breaking the catheter.
When inserting or exchanging the dilatation catheter, wipe the guide
wire once with gauze soaked with physiological saline solution.
Inspect the entire guide wire that neither the lubricity of the surface
has decreased, nor any foreign substances are on the wire. Moving the
catheter over such residues adhered to the guide wire or over a half-
wetted wire, may result in the separation or laceration of dilatation
catheter. This may necessitate the recovery of the catheter fragments.
Monitor the guide wire position under high resolution fluoroscopy during the
exchange.
Read the manufacturer's instructions when catheters other than the Hiryu
are used.
Proceed with care to prevent PTCA dilatation catheter kinking and collapse
when forming the loops.
Secure the PTCA dilatation catheter with the CATHETERCLIP at the
stiffer, proximal end. Do not use the CATHETERCLIP on the flexible,
distal shaft or the PTCA guidewire port of the rapid exchange type
PTCA dilatation catheters, it may damage the PTCA dilatation
catheter.
Proceed with care to prevent shaft kinking and collapse while removing the
CATHETERCLIP.
It is recommended to use the second balloon protection sheath when the
catheter is placed into a bowl of physiological saline solution. Do not reuse
the first balloon protection sheath which is on the catheter, after removing it.
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