Jaws catheter exchange: an alternative method of exchanging coronary interventional devices.

This study describes an alternative method of exchanging over-the-wire (OTW) angioplasty catheters over standard length coronary guide wires. Exchange was facilitated with a specially designed catheter stripper, Jaws (Microvena, White Bear Lake, MN). Jaws is a disposable instrument similar to an electrician's wire stripper whose cutting blades automatically center the wire before cutting the catheter shaft. One hundred seventy catheter exchanges were performed in 93 patients. Catheter extraction success was 99% and reinsertion success was 98%. Catheters were extracted by withdrawing the catheter to the proximal end of the wire and transecting the catheter shaft near the hemostatic valve. All catheters were extracted with two to three cuts. After catheters removal, another OTW, sliding rail, directional atherectomy, Cook, or J&J stent could be introduced over the standard 175 cm wire. In those situations where catheter reuse is unanticipated, Jaws exchange affords the operator a full range of catheter choices with the convenience and economy of using a standard length angioplasty guide wire.