Background/purpose: To study steerable microcatheter (SM) use in moderate and highly difficult vessel selection compared to conventional pre-shaped microcatheter (CM) use. Material and methods: An IRB approved, single institution analysis of 40 complex angiographic procedures with and without superselective microcatheter use during an eight-month period in 2017 was performed. Target vessels were deemed moderate or highly difficult to select based on vessel size, tortuosity, and/or angulation during nonselective initial angiography. Data collected included type of microcatheter used (SM or CM), number of microcatheters and microwires used, procedure time, radiation exposure index (dose area product/DAP), target vessel location, and time to target vessel selection (TTVS; time from device placement to vessel selection). Comparison between the SM and CM groups was performed using Wilcoxon test. Results: A SM (SwiftNinja, Merit Medical, South Jordan, UT, USA) was used to select 46 vessels in 20 patients. One or more CMs were used in 20 patients to select 34 vessels. Median TTVS, number of microwires used, total procedure time, and DAP (microGray. m 2) were 12 vs. 462.5 s (p < 0.0001), 0 vs. 2 (p < 0.001), and 26,948 vs. 30,904 (p = 0.15) in the SM vs. CM groups, respectively. When adjusted for body mass index (BMI) using a linear model for radiation exposure, patients in the SM group had lower radiation exposure than those in the CM group (p = 0.05). Conclusions: Utilization of a steerable microcatheter, without or with a guidewire, leads to easier and faster target vessel selection with shorter procedure times in complex vessel anatomy.

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Can the evaluation tests for dishwashing detergents be used under practical field conditions? What equipment and how much chemical knowledge is needed? Can the tests be easily demonstrated to the restaurant operator? Will the results be of practical value? Sanitarians attending the New York State Public Health Environmental Sanitation Field Training Center at Buffalo, N. Y., are getting the answers to these and other questions concerning tests for dishwashing detergents. In the food and restaurant portion of the 12week field training course, they are obtaining practical experience in evaluating detergents, experience which will aid them in making their routine inspections of restaurants and in helping the restaurant operator select a detergent for his particular needs. Laboratory Evaluation Studies Much work has been done on the laboratory level to evaluate detergents and to test their performance in dishwashing machines. Such recognized authorities as the National Sanitation Foundation at Ann Arbor, Mich., and