Efficacy and Safety of the GuideLiner Mother‐in‐Child Guide Catheter Extension in Percutaneous Coronary Intervention

Abstract

Use of the GuideLiner catheter facilitated successful completion of PCI procedures in a majority of patients with complex lesions. Operators should be aware of the potential complications associated with GuideLiner use.

Patient outcomes in GuideLiner facilitated percutaneous coronary intervention stratified by the SYNTAX score: A retrospective analysis

“…Due to local expertise with the GuideLiner, we tend to use this technique with difficult lesions rather than trying other “buddy wire” methods as at other centers. 8 We had a high rate of successful stent delivery (92%) with final TIMI 3 flow rate of 82%. As interventionalists encounter more complex cases, especially calcific tortuous or previously stented vessels during STEMI, it is important to be aware of tools that can help facilitate PCI and lead to improved patient outcome.…”

“…This high success rate is comparable to previous studies where procedural success rates range from 80.2 to 98.7%. 8,9 The wide range of procedural success rate could be related to differences in the patient population as well as lesion specific characteristics. Our study population had a final TIMI score of 3 in 91% of the cases and this is comparable to the 96% in a previous study.…”

Differences in primary indication for guide-extension catheter usage among the three target vessels

“…GuideLiner V3 (Vascular Solutions Inc., Minneapolis, MN, USA), Guidezilla (Boston Scientific, Marlborough, Massachusetts, USA), or GuidePlus (Nipro Corp., Osaka, Japan) was used. The primary indication for GEC was defined as follows [6,7]: 1) to increase back-up support; 2) as an outer sheath; 3) to facilitate co-axial alignment between the catheter and the lesion; 4) to selectively inject contrast; and 5) other. Although the complete differentiation among the indication of 1)-3), especially between 1) and 2), was hard to achieve, we defined the indication of 1)-3) as follows: the indication of 1) was defined in cases where the operators simply would like to increase backup support of a guiding catheter to facilitate delivering stents or a balloon with little awareness of the tortuosity or angle of the vessel proximal to the target lesion; indication of 2) was defined in cases where the GECs have passed beyond the lesions and the devices were delivered; indication of 3) was defined in cases where the tortuosity or acute bending proximal to the target lesions might underlie the difficulty to deliver devices (especially, short monorail with floppy shaft, such as intravascular ultrasound).…”

“…Procedural success was defined as < 20% residual stenosis with thrombolysis in myocardial infarction 3 flow in the target vessel, and device success was defined as delivering GEC to the desired position. Tortuosity was defined as proximal segment angulation of > 90° and calcification was visually assessed [7].…”

“…Applying a similar concept, the rapid-exchange guide extension catheter (GEC) has been evolving. Previous studies have proposed a mechanism of its efficacy as increasing back-up support by deep intubation, as a conduit to decrease friction between the vessel wall and the catheter, or for improving co-axial alignment between the catheter and the lesion [6,7]. However, little is known regarding the differences in primary indication with respect to the target vessels.…”