The use of the GuideLiner™ catheter as a child-in-mother technique: an initial single-center experience

Abstract

Recently, a new interventional guide catheter, the GuideLiner™ catheter, was introduced into the market as a strategy for tackling the problem of stent delivery failure. We implemented this simplified child-in-mother technique in a series of 16 challenging coronary interventions. Balloon and stent delivery was successfully achieved in all cases and the device was both simple to deploy and remove. Apart from two cases of vessel dissection that were managed successfully with stent implantation, no other serious procedural complications were reported.

Use of the GuideLiner catheter for aspiration thrombectomy in a patient with ST-elevation myocardial infarction with a large intracoronary thrombus

“…In our case, final IVUS imaging showed no injury of the proximal LAD due to insertion of the GuideLiner catheter. However, although the tip of the GuideLiner catheter is soft and flexible, there is a potential risk of coronary injury due to deep insertion, especially in patients with proximal atherosclerotic lesions [4,7,8]. Therefore, gentle manipulation of the GuideLiner catheter in coronary arteries is required.…”

“…However, to avoid potential air embolism and distal thromboembolism, operators need to check whether there is air or a thrombus in the guiding catheter after insertion and removal of the GuideLiner catheter. Other potential complications of the GuideLiner catheter include arterial pressure waveform dampening, intimal disruption, perforation of the vessel wall, vascular occlusion, arterial spasm, and damage of the stents [4,8,9,20]. Therefore, the GuideLiner catheter should be used with great care to minimize the risk for these potential complications.…”

“…Because transradial intervention is considered as a safer and more reasonable alternative than the conventional transfemoral approach [14][15][16], we should have performed primary PCI for the present case by the transradial approach. This catheter is usually used for delivery of various devices in patients with coronary artery disease with heavy calcification or severe tortuousity [7][8][9]. An advantage of the GuideLiner catheter is that it is easy to handle with a rapid exchange system because a second hemostat valve is not required.…”

“…However, these devices are not always effective because of the small diameter of the lumen. The GuideLiner catheter (Japan Lifeline, Tokyo, Japan) is used to achieve strong support with a guiding catheter [4][5][6], and delivery of various devices, including stents and balloons [7][8][9], in patients with coronary artery disease with heavy calcification, severe tortuousity, and chronic total occlusion [10,11]. This catheter is designed for the ''Mother and Child'' technique, with a rapid exchange system, and it is easy to handle because a second hemostat valve is not required.…”

Novel Use of the GuideLiner Catheter to Deliver Rotational Atherectomy Burrs in Tortuous Vessels

“…The GuideLiner is a rapid exchange “mother and child” guide extension catheter that allows deep and subselective intubation of the target vessel allowing for improved support during delivery of stents in highly tortuous vessels [1–3]. Rotational atherectomy (RA) which is usually accomplished with the Rotablator burr can facilitate lesion and stent expansion in highly calcific lesions [4].…”