Transcription
Now we're gonna go over how to use a microcatheter system. This is gonna include using a microwire, a torque device; we're gonna kind of combine everything together to kind of establish how to use this type of particular system here.
So a microcatheter is like a regular catheter; however, it is much smaller. So handling it can be a little difficult, and kind of there are unique considerations. This particular catheter we have here is a microcatheter as well. And essentially what we're gonna do is kind of discuss how we're gonna prepare things. Then we have a microwire; this is, you know, not necessarily the exact wire we would use with this catheter, but it's kind of what I have on hand. I'm going to kind of demonstrate the principles here.
So with a microcatheter, it's important to realize that you can't use like a traditional syringe to flush; you need a smaller one to generate enough pressure. So we have like a three CC medallion here. So you can flush the actual microcatheter here with the medallion to kind of prep it. And then if you wanted to, you could flush the outside of the catheter with using a regular syringe as well, too. And then we have our microwire here with our torque device, which we will use later. And then basically what we can do is we can flush this wire using a regular syringe here because we have a hookup, and we can kind of flush through there.
And now we can load, and I would kind of recommend when you're working with, you know, these systems of microwires and microcatheters, loading while they're both still kind of coiled up. I think it's a lot simpler and easier. So what we're gonna do is just load our wire into our microcatheter, like so. There we go. And we'll load this in as much as we can, and we can keep an eye on the other side to see if it comes out all right.
And now what we can do is load our torque device on the back end here. And we'll adjust this later in a second, but kind of how this works is we tighten this down here; we can use this to kind of manipulate things. Now we're gonna take out the whole system together; the wire is in the catheter, like so. All right. And we just have to be mindful of what we're doing here. Okay.
And now what we kind of want to do is readjust our torque device. Here's the end of the catheter and then the wire. What we want to do is kind of readjust our torque device, and we can use and grab an extra towel here, just use it to keep things secure. But we will kind of want to adjust our torque device such that it is a marker of when we're outside or inside of the microcatheter. So at this point, we still have wire that's out here, so I'm gonna kind of pull back my microwire until we're just leading with a little bit of wire. And this is where I'm gonna tighten the torque device. And you can pick how much wire you want to lead with, but the principle is that I'll pull back the torque device to kind of hide the wire, you can see here. And then when I push it in to meet them together, the wire will be out, and I'll be leading with wire. So that's kind of gonna help me there.
Now the other thing to do, we'll hide the wire for now, is to put on what's called this Chewie device. And the whole point of this Chewie device is that it will go over this microcatheter, and this one came in the, and then it can actually be used to hook into a traditional or a larger sized catheter, and it can create a space for flushing in between the micro and the larger catheter. So here I'll show you kind of what I mean. So basically what will happen is with this Chewie device, you can load your microcatheter through it, okay, just like this. And then we'll do it here, so you can see what what you can do here is that you can tighten the Chewie device on the back end here, and what this does is it cinches around the catheter. So now I can't move it forward, and now you've created a space where you can kind of push, and actually what is useful here is to take something like a one-way valve and put it on here so that you don't, you can't get blood coming back when your intravascular. So what I can do here now is kind of plug in, make sure we take all the air out, is that I can plug in and flush through this front area right here. So that is what the Chewie does, and you can also kind of pull back as well, too. Now if you were to open up this area, it would flush back here, but we've tightened this, so it's only gonna flush forward through the Chewie device. All right. So and that's that's a lot of different moving pieces to that puzzle.
And the last thing we'll do here, just as those are a very basic demonstration, I'm just going to loosen the Chewie device for now, is that we're gonna kind of take this whole system together, you know, Chewie, microcatheter, microwire, let's kind of put this off to the side here. And what we're gonna do, oh, and our torque device on the end, is that we're just going to, you know, first we're gonna hide the wire for now, and we'll load this into place into, let's say our, the sheath, pretend this is our larger catheter. So we can kind of load this in, and then we can, like we discussed before, if I push my torque device forward like this, I'll be leading with wire. So now once I'm inside, I can lead with wire, and then what I can do with my Chewie is lock it in to my other catheter here. All right. So I kind of locked it into place, and then when I kind of feed my catheter into, and we can see what's going on here on the other side, I'm leading with wire here. I'm going to tighten my torque device, you know, leading with wire, I'm not as I move the torque back and forth. And then once I get my catheter into appropriate place, I can tighten the back end of my Chewie like so, and now I can flush; I have an area here where I can flush in between my microcatheter and my larger catheter, and then I can also pull back and flush from here.
So this is kind of the microcatheter system. It's a lot of moving pieces to the puzzle; it will become a little bit more irrelevant when you see it in the actual context that it's used, but it's important to be able to understand how to, you know, prepare things, but the microwire and the microcatheter, put the torque device on in an intelligent way where it's it's telling you whether or not wire is out or in, and that you can use that as a measure, and you kind of tighten it so it doesn't move around. And then the Chewie, understanding how the Chewie works, you can put it over the microcatheter, plug it to your larger catheter here, and create an area to inject and flush as needed. So all of those things work together, and it's important to have that in mind before you start using this for the first time.