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Figure 4 :(a) A guide catheter is modified by using the hub of a sheath one Fr size less than the Fr size of the guide catheter. (b) In this instance, a 6 Fr guide catheter is cut to the appropriate length and inserted into the hub of a 5 Fr sheath (which has been cut a "bevel"). (c)The guide catheter provides a buttress for support while a hydrophilic catheter can be used with a guidewire (usually a hydrophilic guidewire) to access and cross the occluded segment. Various guide catheters can be used, depending on the angle required to access the occluded segment

Figure 4 :(a) A guide catheter is modified by using the hub of a sheath one Fr size less than the Fr size of the guide catheter. (b) In this instance, a 6 Fr guide catheter is cut to the appropriate length and inserted into the hub of a 5 Fr sheath (which has been cut a