Deflectable tip guide in guide system

A guiding catheter system for performing myocardial revascularization comprising:

• a first guide tube having a proximal region and a first lumen therethrough, said first lumen having an inside surface;
• a second guide tube having a proximal region and a second lumen therethrough, said second guide tube being disposed at least partially in said first tube first lumen and having an outer surface opposing said first tube inside surface;
• and
• means for resisting free rotation between said first and second tubes.

A guide catheter for performing myocardial revascularization comprising:

• an elongate tube having a distal region, a distal end, a proximal region, a first lumen therethrough, and a longitudinal center axis;
• a second lumen extending from said proximal region to at least said distal region;
• and
• an elongate manipulation member disposed in said second lumen, being accessible from said proximal region, and being operably secured to said tube distal region at a location off-center from said tube longitudinal center axis, such that said-tube distal region can be bent by proximally pulling on said manipulation member.