Classification of Sheaths

Catheter sheaths are the most utilized access devices for transvascular interventions. It can be said that basically all vascular interventions use catheter sheaths to establish the surgical access, therefore the selection of catheter sheaths for successful establishment of the surgical access is essential for the success of the intervention.

The catheter sheath can be used to establish the first gate of vascular access through a dilatation tube and a sheath tube in simple coordination. Subsequent catheters and instruments are delivered to the lesion site through the sheath in the blood vessel.

Classification of sheaths
Sheaths can be divided into radial artery sheaths and femoral artery sheaths by the site of puncture, single-layer polymer sheaths and metal-reinforced sheaths by the material, and long sheaths and short sheaths by the length of the catheter sheath. There are also special sheaths including torsion hill sheaths, thin-walled sheaths and tearable sheaths.

The radial artery sheaths are generally 4F-7F in outer diameter, with 5F and 6F being the most common sizes, and 7F being used in some men, while the femoral artery sheaths are generally 4F and above in outer diameter.

The single-layer polymer sheath, whose main body is made of polymer material, is generally one of PE/PTFE/FEP, which is characterized by low production cost, weak bending resistance, easy bending of the lumen, and weak support. The metal reinforced sheath is usually covered with hydrophilic coating, which is characterized by high production cost, strong bending resistance, easy deformation of the lumen and strong support.

Short sheaths are suitable for general vascular puncture and imaging, and their sizes are generally 4F-14F, with lengths ranging from 7cm to 25cm. long sheaths are suitable for long-distance puncture points, with sizes ranging from 4F-26F, and lengths of 25cm or more.

Tearable sheaths are used in some special instrument delivery where the sheath cannot be left because of the attached fittings, at this time it is necessary for the sheath to be able to be torn from the outside, backing up as it goes, until all of it is left, and this type of sheath is called a tearable sheath.

Thin-walled sheaths are smaller wall thicknesses in the same size, making the outer diameter of thin-walled sheaths smaller, allowing for “larger lumens” and “thinner walls”. The Overtop Sheath is a long vascular sheath that is used for vascularization of the contralateral limb by crossing the main bifurcation of the guidewire catheter.

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