Superficial Femoral Artery

"In our practice, the Glidewire is the initial wire of choice for traversing complex, calcified and long-segment SFA lesions. The visibility, one-to-one torque control, availability of sizes and tip configurations, and smooth tapered transition of the Glidewire system allows reliable lesion crossing even in the most complex scenarios."

Dr. John H. Rundback
Interventional Radiologist

Aortoiliac Bifurcation

"The gradual and longer taper of the wire allows me to obtain purchase on the contralateral side without the stiffness of the leading edge of the wire causing the catheter to recoil into the abdominal aorta. I start by advancing a 4 Fr Cobra catheter over this bifurcation into the contralateral (left) internal iliac, which is made much easier in sharply angulated turns such as this one, by using the long-taper Glidewire. This arrangement also saves me the step of having to use another sharply angulated catheter such as a RIM or Simmons 1 to cross the bifurcation, then have to switch to a non-recurved catheter to access the internal iliac artery and provide the best approach for microcatheter access to the left uterine artery. Instead, I can do all that with the single combination of the Cobra catheter and the long-taper Glidewire."

Dr. Joseph Bonn
Interventional Radiologist

Uterine Artery

"Once in the uterine origin, using a coaxial system, as most of us do, one has to make a hairpin 180-degree turn cephalad, followed quickly by a similar hairpin turn caudad before entering the descending uterine artery segment. This series of turns requires one to not only have an angled wire that will make the turns, but one elastic enough not to buckle out into the anterior division when one applies the force to the wire sufficient enough to advance it through these turns. I had struggled through many of these arteries for years, even with a 70-degree 0.018" Glidewire, but with the advent of the double angle Glidewire GT, I hardly think twice about whether I will succeed. It is the perfect wire for this highly demanding, and frequent, technical situation."

Dr. Joseph Bonn
Interventional Radiologist

Aorta

"The diagnostic arteriogram from a 66-year-old white woman was obtained from a left brachial approach and showed an occlusion of the infrarenal aorta immediately inferior to the renal arteries to the level of the inferior mesenteric artery (IMA). The celiac and superior mesenteric arteries (SMA) were widely patent, with the SMA filling the IMA. The IMA then filled the distal aorta and lower extremities. Both the common, internal, and external iliac arteries were quite small but patent, along with the common, profunda, and superficial femoral arteries. A Doppler Smart needle (Escalon Vascular Access, New Berlin, WI) was used to cannulate the common femoral artery (CFA) and a 5 Fr sheath (Terumo Medical Corporation) was introduced. A 0.035" Wholey wire (Mallinckrodt, Hazelwood, MO) was utilized initially to traverse the aortic occlusion. Because the Wholey wire can traverse "new" clot well and "old" clot poorly, this maneuver discriminates "old" versus "new" occlusions. After several failed attempts, it was apparent that the occlusion was older than anticipated based on the history. A combination of a 5 Fr, angled, Glidecath (Terumo Medical Corporation) and a 0.035" Glidewire (Terumo Medical Corporation) was used, and the wire and catheter reached the descending thoracic aorta."

Jason S. Carlson, RT
Bruce H. Gray, DO

Hepatic

"The Glidecath XP has tremendous stability; it stays put during embolization cases and prolonged interventions. I can pass stainless steel coils through the lumen without fear of being kicked out. When using the 5 Fr version in a variety of shapes it is very torqueable, directional, and extremely visible. Coils, particles, and coaxial catheter systems flow transparently through this design. Where it once took extreme training and skill to perform complex embolization procedures-GI bleeders, pelvic embolizations, extremity, splenic, hepatic embolizations or distal cannulations-it is now simply and easily accomplished with the trackability and maneuverability of this device."

Dr. Gary Cohen
Interventional Radiologist

Uterine Artery

"There is only one catheter on the market that fits my criteria: the Progreat Coaxial System. This system has replaced all other microcatheters in my IR. I use it in a wide assortment of cases, but most commonly for embolizations. In chemoembolizations it easily gains entry to the distal tumor vascularity, is highly visible, and delivers my cocktail of chemotherapeutic agents, together with particulates and ethiodol, without fear of occlusion."

"The catheter is highly stable, with no need for replacement, even during prolonged procedures. I enjoy the rapid deployment, so that I can be the sole operator without assistants. The catheter is simply flushed with the pre-inserted Glidewire and I can begin. There is no need for tedious and cumbersome insertion of a separate long wire guide into this catheter before insertion."

"If the included Glidewire* does not allow cannulation of difficult uterine arteries or vessels, an exchange for the Glidewire GT (with double curve) is all that is necessary to complete my cannulation and complete my case. The 10 cm extension of wire allows enough length to advance the wire into the target vessel and give stability to advance the Progreat microcatheter. This is a great improvement over competitive products and a tremendous advance for patient care."

Dr. Gary Cohen
Interventional Radiologist

*The Progreat^™ Coaxial Microcatheter System is pre-loaded with the Terumo Glidewire^® GT (Shapeable Tip).

Carotid

"Even in this difficult aortic arch, with a congenitally anomalous short left common carotid artery, the Pinnacle Destination Sheath has functioned very well. It tracks well into difficult anatomy and it remains in position within the common carotid artery despite tortuousity and seemingly unstable anatomic configurations."

Dr. Kenneth Ouriel
Vascular Surgeon

Spasm

"After trying the multitude of sheaths that are on the market, I have found that the Terumo Glidesheath is the best sheath for preventing spasm. Its smooth taper and hydrophilic coating lead to easy insertion; and we have found no long-term complication from the use of the sheath."

Dr. John Coppola
Interventional Cardiologist

Renal

"I have been performing endovascular procedures for about 10 years now. Over that time, I have used and/or experimented with just about every new device that's come out. Before I started using the Terumo Pinnacle Destination Sheath for renals, a lot of my time was wasted trying to get the balloon/stent across the lesion because my wire would usually flop out of the renal artery. Also, it was extremely hard identifying the aortorenal interface as the balloon/stent crossed the lesion. The distinct right angles that sometimes are present with renals will kick out the catheter/wire as these devices move into the renal artery and attempt to cross lesions."

"The angled Terumo Pinnacle Destination Sheath easily goes right from my femoral/brachial access to the aortic/renal interface. The angled sheath is soft enough to gently make the 90° turn into the renal, yet sturdy enough to stay put as wires and balloons/stents are interchanged. Tiny puffs of contrast enable total procedure identification of the lesion and its relationship to the aorta as the monorail balloon/stent delivery system passes through the Pinnacle Destination Sheath and to its target area."

"The Terumo Pinnacle Destination Sheath has made my renal cases quick, easy, and most importantly, safe for my patients."

Dr. Ashish K. Gupta
Vascular Surgeon