Guide Extension Catheter-assisted Interventions - A Single-Centre Experience

Abstract

Objective: To evaluate the technical and procedural success and safety of guide extension catheter-assisted percutaneous coronary intervention (PCI) in challenging and complex coronary lesions. Methods: A physician-initiated, observational study conducted at a tertiary care centre in India between July 2021 and July 2022. The patients who underwent guide extension catheter-assisted PCI with the indication of facilitating stent delivery and deployment were consecutively enrolled in the study. Complete medical records including history, demographics and clinical characteristics, and angiographic data of patients who underwent guide extension catheter-assisted PCI were reviewed and noted. Results: Total 19 patients were included in the study of which 18 underwent guide extension catheter-assisted PCI, and one patient internal carotid artery angioplasty. The mean of patients was 62.74±10.38 years ranging from 42 years to 82 years. Total 9 (47.3%) patients were presented with chronic stable angina, 8 (42.1%) with unstable angina and only one patient represented acute myocardial infarction. The right coronary artery (RCA) was the most common target vessel involved in (63.2%). Total 31.6% lesions were distally located, 57.9% were heavily calcified, and 10.5% lesions were chronic totally occluded. A 100% procedural success was noted with the use of guide extension catheter. No case of stent disruption, vessel dissection or ventricular arrythmias and in-hospital death or myocardial infarction were noted during hospital-stay. Only one case of small access site hematoma was reported. Conclusion: The study concluded that the use of guide extension catheter facilitates easy advancement of stents or other devices through tortuous, heavily calcified, distal, bifurcations and CTOs coronary as well as carotid lesions. However, larger studies on wide range of patient population are required to validate our findings. Keywords: percutaneous coronary intervention, coronary artery, carotid artery, guide catheters