rapidexchange

Rapid exchange is a catheter design and procedural approach used in interventional cardiology and radiology to facilitate quicker device exchanges during endovascular procedures. The term refers both to a specific catheter geometry and to the technique of exchanging interventional devices with minimal rewiring.

In a rapid-exchange system, the guiding wire exits the catheter through a short proximal segment near the hub, rather than running the full length of the catheter. This arrangement allows the operator to remove a spent device and advance a new one over the same guidewire with fewer steps, often enabling exchanges by a single operator and with simplified handling.

Rapid exchange contrasts with over-the-wire systems, in which the guidewire extends through the entire length of the catheter. OTW exchanges generally require more time and catheter manipulations. The RX approach can reduce procedural time, radiation exposure, and contrast use, but may offer different levels of support and maneuverability depending on the anatomy and device being used.

The technique is widely used in coronary and peripheral interventional procedures, including balloon angioplasty, stent delivery, and the use of microcatheters and other exchangeable devices. It is implemented through various manufacturer platforms, each with its own design specifics, while the underlying principle remains to shorten exchange steps.

Overall, rapid exchange is a commonly adopted concept in modern endovascular practice, chosen for its potential efficiency gains and operator convenience, balanced against anatomical considerations and device requirements.