GuideLiner catheter application in complex coronary lesions: experience of two centers

Dursun, Hüseyin; Taştan, Ahmet; Tanriverdi, Zulkif; Özel, Erdem; Kaya, Derya

doi:10.5152/anatoljcardiol.2015.6214

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…The mean depth of intubation in our study was 42 ± 19 mm (minimum for ostial lesion of LCX, and maximum 92 mm for SVG graft) (Fig. 10c), which is similar to that reported by Chan et al [5] and Dursun et al [14] though the longest intubation depth is 120 mm as reported by Ma et al [15]. Much deeper intubation of Guidezilla device may cause entire segment to prolapse outside ostium of coronary artery, impairing withdrawal of device, and with loss of co-axiality.…”

Section: Discussionsupporting

confidence: 91%

The Safety and Efficacy of Guidezilla Catheter (Mother-in-Child Catheter) in Complex Coronary Interventions: An Observational Study

et al. 2019

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BackgroundLesion characteristics (anatomy, calcification, tortuosity and angulation), vessel morphology, and lack of support add complexity of coronary intervention. Guidezilla catheter, acting as an extension of guide catheter system (mother-in-child catheter), helps to overcome these complexities by enhancing backup during complex intervention.MethodsThe present retrospective, single-center study included 13,157 consecutive patients who underwent percutaneous coronary intervention (PCI) through both transfemoral and transradial routes from January 2015 to July 2019 at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India among which Guidezilla™ catheter (Boston Scientific, Natick, MA, USA) was used in 156 patients. Study endpoints were target lesion crossing, procedural success, and complications. The clinical, angiographic and procedural data of all 156 patients were evaluated to assess safety and efficacy of Guidezilla extension catheter (GEC).ResultsThe mean age of the enrolled patients was 61.2 ± 8.67 years. Type-C lesion was commonest (69.9%) followed by B2 (22.4%) and B1 (7.7%). The commonest indication for its use was tortuosity (30.1%) followed by calcification (21.1%), angulation (18.8%), chronic total occlusion (17.9%), distally located lesion (8.3%), and anomalous origin of vessel in 3.8%. The right coronary artery (39.2%) was most commonly intervened artery followed by left anterior descending (LAD) (30.8%), left circumflex (LCX) (19.9%), multivessels (7.6%), and saphenous vein graft in 2.5%. The mean depth of intubation was 4.2 ± 1.9 cm. Mean diameter of stents was 34.2 ± 14.4 mm while mean length of stents was 31.2 ± 10.2 mm. Lesions were modified using aggressive pre-dilatation in 87.8%, followed by cutting balloon in 10.9%. GEC was delivered across the lesion using buddy wire technique (9.6%), balloon-assisted tracking (BAT) in 30.1%, and balloon-assisted sliding and tracking (BLAST) in 4.5% of patients. Stent implantation was successful in 151 out of 156 patients with success rate of 96.7%. Overall failure rate was 3.3% which was contributed by extreme tortuosity, angulation, and severe calcification. Guidezilla-associated procedural complication (dissection, stent dislodgement, shaft breakage) were reported in three patients (1.9%) who were successfully managed.Conclusions Guidezilla system acting as mother-in-child extension catheter is a safe and effective tool which provides additional backup support and increases success rate of PCI for complex coronary lesions.

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Section: Discussionsupporting

confidence: 91%

The Safety and Efficacy of Guidezilla Catheter (Mother-in-Child Catheter) in Complex Coronary Interventions: An Observational Study

et al. 2019

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“…In our present study, the lesion morphologyis very much similar to Dursun et al (2016) 12 who presented a 64 patients study using the GuideLiner ® catheter, with the majority of patients having ACC/AHA types B2/C lesions.In the present study success of stent deployment is 16 out of 19 cases (84.2%), which also very much resembles the study by to Dursun et al (2016) 12 , although it was through trans-femoral route. In addition, we found that this device showed an excellent safety profile since no coronary dissection was induced.…”

Section: Discussionsupporting

confidence: 76%

Angiographic Analysis of Trans-Radial Percutaneous Coronary Intervention Cases by the Backup Support of Guide Extension Catheter

Nasrin

Cader²,

Haq³

et al. 2018

Bangladesh Heart J

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Background:The guide extension catheter -Guidezilla (Boston Scientific, United States of America) is a useful adjunctive tool in percutaneous revascularization of complex coronary lesions, and provides an extensionto the guide catheter with better coaxial alignment, support and stability.Objective: The objective of this study was to describe the usefulness and easy deliverability of stent by Guidezillain the trans-radial treatment of complex coronary lesions as our initial experience.Methods:This prospective observational study was conducted at the . The transradial approach was used in all cases. Clinical, angiographic and procedural data of percutaneous coronary interventions performed using Guidezilla, including indications for use of Guidezilla were collected and analyzed. Results:A total of 19 procedures (in 18 patients) were evaluated. 57.89% of cases were related to left circumflex coronary artery or obtuse marginal branch. The commonest challenge for use of Guidezillawas proximal angulation (63.15%) and calcification (47.4%). Commonest type of lesion was ACC/ AHA Type C lesion (63.2%). Successful stent deployment was achieved in 16 of the 19 procedures (84.2%). Among the unsuccessful cases, there was stent damage in one case and distal dissection after deployment of a stent in other. Stent deployment was not possible in two cases, due to diffuse lesion and heavy calcification.Conclusions:Guide extension catheter is a good trans-radial back-up support for calcified, complex and tortuous coronary anatomy, which otherwise may have been considered unsuitable for PCI. The use of such support can reduce the necessity for the more expensive alternative of deploying multiple small stents in order to traverse the lesions.

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“…Several studies have shown the safety and utility of GuideLiner catheter in complex coronary interventions involving ACC/AHA type B2 or C lesions . GuideLiner is an important adjunctive tool in CTO interventions where it is difficult to deliver a balloon or microcatheter across the lesion .…”

Section: Discussionmentioning

confidence: 99%

Utility of the guideliner catheter for percutaneous coronary interventions in patients with prior transcatheter aortic valve replacement

Bharadwaj

Bhatheja

Sharma

et al. 2017

Cathet Cardio Intervent

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The safety and utility of GuideLiner catheters in complex percutaneous coronary interventions (PCI) has been well established. Patients with prior trans-catheter aortic valve replacement especially with CoreValve, who present for PCI, pose a unique set of challenges. Not only does the operator often encounter difficulty with selective engagement of coronary ostia through the struts of the CoreValve, but also the complex nature of the underlying CAD in this high-risk population. We present a case series to illustrate the use of GuideLiner catheter as an adjunctive tool for PCI in this patient population.

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GuideLiner catheter application in complex coronary lesions: experience of two centers

Cited by 11 publications

References 21 publications

The Safety and Efficacy of Guidezilla Catheter (Mother-in-Child Catheter) in Complex Coronary Interventions: An Observational Study

The Safety and Efficacy of Guidezilla Catheter (Mother-in-Child Catheter) in Complex Coronary Interventions: An Observational Study

Angiographic Analysis of Trans-Radial Percutaneous Coronary Intervention Cases by the Backup Support of Guide Extension Catheter

Utility of the guideliner catheter for percutaneous coronary interventions in patients with prior transcatheter aortic valve replacement

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