- What is a Guiding Sheath?
- Details of each product
- Terumo Corporation 【Destination】
- Terumo Corporation 【Destination EX】
- Terumo Corporation 【Destination Slender/Slen Guide】
- Medikit Co., Ltd. 【Parent Plus】
- Medikit Co., Ltd. 【Parent Select】
- Medikit Co., Ltd. 【Parent Cross】
- Medicon Inc.(BD) 【Halo One】
- Nipro Corporation 【CROSS ROADS MG】
- Cordis Corporation【Brite Tip RADIANZ】
- Tokai Medical Products, Inc.【OPTIMO PPI】
- “Thin-Walled Sheath Ranking (Ordered from Thinnest Wall)”
- Ranking of Sheath Lumen Sizes (From Widest to Narrowest)
What is a Guiding Sheath?
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.
| Standard | Effective Length(cm) | Shape |
| 5Fr | 45/90 | Straight/Multipurpose |
| 6Fr | 30/45/90 | Straight |
Terumo Corporation 【Destination EX】
| Standard | Effective Length(cm) | Shape |
| 7Fr | 45 | Straight |
| 8Fr | 45 | Straight |
Terumo Corporation 【Destination Slender/Slen Guide】
| Product Name | Effective Length(cm) | Shape |
| Slender | 119/149 | Straight |
| Slen Guide | 119/150 | Straight |
Medikit Co., Ltd. 【Parent Plus】
| Product Name | Effective Length(cm) | Shape |
| ParentPlus30 | 21/50/90 | Straight |
| ParentPlus45 | 21/38/43/53/63/78/93/103 | Straight/Angle(43)/Hook45°(53) |
| ParentPlus60 | 21/43/48/68/88/93/103 | Straight/Angle(43･48)/MP(88) |
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】
| Product Name | Effective Length(cm) | Shape |
| ParentSelect4575 | 53/93 | Straight |
| ParentSelect5082 | 21/53/93 | Straight |
| ParentSelect60Pro | 21/53 | Straight |
Medikit Co., Ltd. 【Parent Cross】
| Standard | Effective Length(cm) | Shape |
| 6Fr | 43 | Straight |
| 7Fr | 21/43/68/93 | Straight |
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】
| 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】
| Standard | Effective Length(cm) | Shape |
| 6Fr | 110/135 | Straight |
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)
| Product Name | Standard | Inner Diameter | Outer Diameter | OD-ID |
|---|---|---|---|---|
| Destination EX | 8Fr | 0.115 | 0.136 | 0.021 |
| Parent Cross | 7Fr | 0.102 | 0.122 | 0.020 |
| Destination EX | 7Fr | 0.101 | 0.122 | 0.021 |
| Parent Select 60Pro | 6Fr | 0.100 | 0.111 | 0.011 |
| Crossroads MG | 対側用 | 0.091 | 0.113 | 0.022 |
| Crossroads MG | 同側用 | 0.089 | 0.107 | 0.018 |
| Parent Plus | 60 | 0.088 | 0.110 | 0.022 |
| Parent Cross | 6Fr | 0.088 | 0.110 | 0.022 |
| R2P SlenGuide | 6Fr | 0.087 | 0.093 | 0.006 |
| R2P Destination Slender | 6Fr | 0.087 | 0.098 | 0.011 |
| Brite Tip RADIANZ | 6Fr | 0.087 | 0.100 | 0.013 |
| Destination | 6Fr | 0.087 | 0.109 | 0.022 |
| Halo One | 6Fr | 0.086 | 0.097 | 0.011 |
| Parent Select | 5082 | 0.082 | 0.094 | 0.012 |
| Destination | 5Fr | 0.076 | 0.097 | 0.021 |
| Parent Plus | 45 | 0.075 | 0.085 | 0.010 |
| Parent Select | 4575 | 0.075 | 0.085 | 0.010 |
| Crossroads MG | 同側4.5Fr | 0.075 | 0.087 | 0.012 |
| Halo One | 5Fr | 0.074 | 0.084 | 0.010 |
| Halo One | 4Fr | 0.061 | 0.071 | 0.010 |
| Parent Plus | 30 | 0.059 | 0.069 | 0.010 |
コメント