A guiding sheath is a dedicated vascular access device employed in Endovascular Therapy (EVT) for peripheral arterial interventions. In contrast to conventional introducer sheaths, guiding sheaths are constructed with an embedded metallic braid within the shaft, significantly enhancing kink resistance and torque control. They are manufactured in a variety of tip configurations, lengths, and inner diameters, enabling tailored selection based on anatomical considerations and procedural demands.
The guiding sheath is typically advanced to a position as close as safely possible to the target lesion, serving as a stable conduit that facilitates the delivery and exchange of endovascular devices. By reducing the distance from the vascular access point to the treatment site, the sheath improves device trackability, procedural efficiency, and overall operator control.
Guiding Sheath vs. Guiding Catheter: Key Differences in EVT Applications
The main difference between a guiding catheter and a guiding sheath lies in their structural roles. A guiding catheter requires the use of a separate introducer sheath for vascular access, whereas a guiding sheath functions as both the access sheath and the guiding conduit. In other words, the guiding sheath is designed to be used sheath-less, integrating the functions of both components into a single device.
Overview of Commonly Used Guiding Sheaths and Guiding Catheters
This section provides an overview of the guiding sheaths and guiding catheters commonly used in EVT procedures. Only devices that can be used to complete the entire procedure—from initial access to final device delivery—are included. Catheters that serve primarily as supportive tools, such as the Mac-One, Bright Tip (only RADIANZ is listed), and GOGO catheter, have been excluded from this list.
Company Name
Product Name
Usage
Terumo Corporation
Destination
Guiding Sheath
Terumo Corporation
Destination EX
Guiding Sheath
Terumo Corporation
R2P Destination Slender
Guiding Sheath
Terumo Corporation
R2P SlenGuide
Guiding Catheter
Medikit Co., Ltd.
Parent Plus
Guiding Sheath
Medikit Co., Ltd.
Parent Select
Guiding Sheath
Medikit Co., Ltd.
Parent Cross
Guiding Sheath
Medicon Inc.(BD)
Halo One
Guiding Sheath
Nipro Corporation
Crossroads MG
Guiding Sheath
Cordis Corporation
Brite Tip RADIANZ
Guiding Sheath
Tokai Medical Products, Inc.
OPTIMO PPI
Guiding Sheath
Note: The R2P SlenGuide requires the use of a 7 Fr sheath that can be inserted via the radial artery, such as the Glidesheath Slender 7 Fr or Medikit’s thin-walled sheath 7 Fr.
Details of each product
Terumo Corporation 【Destination】
The 6 Fr Destination has an outer diameter of 8.3 Fr. However, when used in a sheath-in-sheath configuration, it is generally compatible with a standard 8 Fr introducer sheath.
The Parent Plus 45 (53 cm) is available in two tip configurations: straight and hook45°. The Parent Plus 60 (43 cm) is available in two tip configurations: straight and angled. The Parent Plus 60 (88 cm) is available in two tip configurations: straight and multipurpose.
Medikit Co., Ltd. 【Parent Select】
Medikit Co., Ltd. 【Parent Select】
Product Name
Effective Length(cm)
Shape
ParentSelect4575
53/93
Straight
ParentSelect5082
21/53/93
Straight
ParentSelect60Pro
21/53
Straight
Medikit Co., Ltd. 【Parent Cross】
Medikit Co., Ltd. 【Parent Cross】
Standard
Effective Length(cm)
Shape
6Fr
43
Straight
7Fr
21/43/68/93
Straight
Medicon Inc.(BD) 【Halo One】
Medicon Inc.(BD) 【Halo One】
Standard
Effective Length(cm)
Shape
4Fr
10/25/45/90
Straight
5Fr
10/25/45/90
Straight
6Fr
10/25
Straight
Nipro Corporation 【CROSS ROADS MG】
Nipro Corporation 【CROSS ROADS MG】
Standard
Effective Length(cm)
Shape
4.5Fr
55
Straight
6Fr the same side
25/55
Straight
6Fr the opposite side
45/90
Straight
Cordis Corporation【Brite Tip RADIANZ】
Cordis Corporation【Brite Tip RADIANZ】
Standard
Effective Length(cm)
Shape
6Fr
110/135
Straight
Tokai Medical Products, Inc.【OPTIMO PPI】
Tokai Medical Products, Inc.【OPTIMO PPI】
Standard
Effective Length(cm)
Shape
6Fr equivalent
25/50
Straight (with balloon)
“Thin-Walled Sheath Ranking (Ordered from Thinnest Wall)”
Product Name
Standard
Inner Diameter
Outer Diameter
OD-ID
R2P SlenGuide
6Fr
0.087
0.093
0.006
Halo One
4Fr
0.061
0.071
0.010
Parent Plus
30
0.059
0.069
0.010
Parent Plus
45
0.075
0.085
0.010
Parent Select
4575
0.075
0.085
0.010
Halo One
5Fr
0.074
0.084
0.010
R2P Destination Slender
6Fr
0.087
0.098
0.011
Halo One
6Fr
0.086
0.097
0.011
Parent Select60Pro
6Fr
0.100
0.111
0.011
Parent Select
5082
0.082
0.094
0.012
Crossroads MG
4.5Fr
0.075
0.087
0.012
Brite Tip RADIANZ
6Fr
0.087
0.100
0.013
Crossroads MG
the same side
0.089
0.107
0.018
Parent Cross
7Fr
0.102
0.122
0.020
Destination EX
7Fr
0.101
0.122
0.021
Destination
5Fr
0.076
0.097
0.021
Destination EX
8Fr
0.115
0.136
0.021
Destination
6Fr
0.087
0.109
0.022
Parent Plus
60
0.088
0.110
0.022
Parent Cross
6Fr
0.088
0.110
0.022
Crossroads MG
the opposite side
0.091
0.113
0.022
Ranking of Sheath Lumen Sizes (From Widest to Narrowest)
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