Guidezilla™ guide extension catheter I for transradial coronary intervention

Abstract

BackgroundPercutaneous coronary intervention (PCI) is the preferred treatment method for coronary artery diseases (CAD). This study aimed to evaluate the effectiveness and complications of the Guidezilla™ guide extension catheter I (GGEC I) in transradial coronary intervention (TRI).MethodsThis case series study included patients with CAD who underwent TRI using the GGEC I between August 2016 and January 2019 at the First Affiliated Hospital of Xi’an Jiaotong University.ResultsA total of 221 patients aged 65.1 ± 9.26 years were included. Coronary angiography results indicated that most patients (77.8%) had triple-vessel lesions, including 47.5% with chronic total occlusion (CTO). A total of 237 target lesions were treated, most being type C lesions (95.8%). The most common indication for GGEC I use was heavy calcification (67%), followed by extreme tortuosity (12.2%), extreme tortuosity and heavy calcification (10.9%), distally located lesion (4.5%), picking up the retrograde wire (3.2%), anomalous vessel origin (1.8%), and releasing the burr incarceration (0.4%). The mean operation time was 58 min, and the overall success rate was 94.1%. Four patients received a drug-coated balloon. No significant differences were found in operation time and success rate among the low (<23), intermediate (23–32), and severe (>32) CAD groups based on SYNTAX score stratification (P > 0.05). Two subacute thrombosis cases each were reported perioperatively, during hospitalization, and at the 1-month follow-up.ConclusionThe GGEC I might have advantages for TRI and is unaffected by SYNTAX score stratification.

Case Report: Thrombus aspiration and in situ thrombolysis via a Guidezilla guide extension catheter in a patient with high-risk pulmonary embolism

“…The Guidezilla (Boston Scientific, Marlborough, MA, USA) guide extension catheter (GEC) is widely applied in complex percutaneous coronary intervention (PCI) for facilitating deep culprit vessel intubation by enhancing the additional backup support of the guiding catheter ( 5 ). As a mother-in-child catheter, the Guidezilla GEC has a larger diameter to enable various interventional devices for performing complicated procedures, which may be applicable for massive PE as an alternative in the absence of dedicated techniques and surgical thrombectomy.…”

Commentary: Coronary stent deformation induced by guide catheter extension

“…We read with great interest the elegantly written article by Lei et al regarding the use of the Guidezilla I (Boston Scientific) guide catheter extension (GCE) during transradial percutaneous coronary intervention (PCI) ( 1 ). The authors report excellent efficacy and safety in the utilization of GCE during PCI, irrespective of the SYNTAX score ( 1 ).…”

“…We read with great interest the elegantly written article by Lei et al regarding the use of the Guidezilla I (Boston Scientific) guide catheter extension (GCE) during transradial percutaneous coronary intervention (PCI) ( 1 ). The authors report excellent efficacy and safety in the utilization of GCE during PCI, irrespective of the SYNTAX score ( 1 ). The authors mention shaft breakage, stent stripping or dislodgement, coronary artery dissection/perforation, and entrapment as possible complications when using GCEs ( 1 ).…”

“…The authors report excellent efficacy and safety in the utilization of GCE during PCI, irrespective of the SYNTAX score ( 1 ). The authors mention shaft breakage, stent stripping or dislodgement, coronary artery dissection/perforation, and entrapment as possible complications when using GCEs ( 1 ). Even though GCEs facilitate the delivery of intracoronary material (stents, balloons), in complex coronary anatomies (calcification, tortuosity, presence of previous stents) stent damage induced by GCE has been reported ( 2 – 4 ).…”