![]() ![]() Moreover, the aim of this article is to help interventional cardiologists using the device in difficult lesions to avoid potential complications. We describe here our experience with the Guideliner catheter for stent delivery and backup support we discuss its utility and drawbacks in acute and stable clinical settings. In our experience, the Guideliner catheter is safe to use and helps device delivery in difficult settings. In 2 cases, we had stent damage due to the passage of the stent through the Guideliner metal collar. Three proximal dissections were detected and sealed with stent implantation. The other 9 cases were performed successfully. One case, the first one, failed, as stent could not be delivered to the target lesion. In 2 cases PTCA with drug-eluting balloon was performed in the other cases second-generation drug-eluting stent was implanted. ![]() In 3 cases the operator chose the femoral access, in 2 cases crossover from radial to femoral access was needed, and the other cases were performed radially. Recently, a new support rapid exchange catheter, the Guideliner, has been designed specifically for device delivery.įrom June 2010 to December 2010, we performed 10 cases using the Guideliner catheter to improve backup support and facilitate stent delivery: 2 emergent PCI for ST elevation myocardial infarction, and 8 stable elective PCI. Stent delivery in complex coronary anatomy with severe calcification and tortuosity is still a common cause of percutaneous coronary interventions (PCI) failure. Procedural success rate was high and there were no major complications. GL-use resulted in increased back-up and guide catheter alignment for stent delivery in unfavourable tortuous coronary anatomies and complex, heavily calcified, and often distally located lesions, which otherwise may have been considered unsuitable for PCI. There were no major complications and two minor complications managed without clinical sequelae: one air embolism and one stent dislodgement. ![]() Indications were to increase back-up of the guide and facilitate stent delivery (59% 41/70), achievement of coaxial alignment of the guide catheter (29% 20/70), and selective contrast injections (13% 9/70). The GL was mainly used for PCI of complex coronary lesions: 97% (68/70) had American Heart Association/American College of Cardiology (AHA/ACC) lesion types B2/C 53% (37/70) were distally located and 23% (17/70) were heavily calcified. We prospectively recorded patient and procedural details, technical success, and in-hospital outcome of 65 consecutive patients undergoing "5-in-6" Fr GL-facilitated PCI of 70 target vessels. We aimed to assess feasibility and safety of GL-use in routine clinical practice. The GuideLiner™ (GL) (Vascular Solutions Inc., Minneapolis, MN, USA) is a guide catheter extension system that provides active back-up support by deep coronary intubation. ![]() Optimal ostial seating and adequate back-up of guide catheters are required for challenging percutaneous coronary interventions (PCI). The manuscript provides a complete summary of the different uses and limitations of the catheter and its contemporary role in modern day coronary intervention. Nuances about use and tips and tricks related to the device are also discussed in the case examples. The angiograms of all those cases were reviewed and selections of cases highlighting different uses of the catheter were chosen for inclusion in this manuscript.Īll potential uses of the GuideLiner catheter are described in this manuscript. The database of coronary interventions at Banner Good Samaritan Medical Center was queried for use of the GuideLiner catheter and stents. These include use of buddy wires, anchoring balloons at different locations for extra support for device delivery, and even rotational atherectomy in the most calcified lesions. Different techniques to enhance guiding catheter support and facilitate device delivery have been described. The objective of this manuscript is to familiarize interventionalists with this new device, describe its versatile uses, and its limitations with case-based examples.įailure of stent delivery is responsible for 5% of procedural failures in coronary interventions in the current era. The GuideLiner catheter (Vascular Solutions, Inc.) is a monorail guiding catheter extension that serves to facilitate stent delivery and is approved for providing extra support and coaxial guide engagement. ![]()
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