8/6/2023 3 Comments 6 fr guidelinerIn experienced hands, reopening rates exceed 85%. If significant myocardial ischemia exists combined with clinical symptoms due to ischemia, recanalization is indicated left ventricular function can be improved, more invasive therapies like coronary artery graft surgery can be avoided at lower complication rates, and even the prognosis of the disease can be improved in suitable cases with both a short-term and long-term survival benefit. Ī strong and stable backup of the guide catheter is essential to advance guidewires, balloons, and stents over the lesion in highly calcified and tortuous vessels. Regardless of the clinical setting, an enhanced backup provides one of the most important preconditions to ensure guide wire and balloon advancement and stent delivery, thereby enabling a successful percutaneous coronary intervention (PCI). Additionally, the use of stiffer wires, the anchoring balloon technique, and deep intubation of the guiding catheter may be applied to improve the backup support. ![]() Various companies have implemented guiding catheter extensions in their portfolio to overcome the problem of a poor backup support. IMDS produces the Guidion (IMDS, Roden, Netherlands) catheter which has a more flexible atraumatic distal end. The Guidezilla (Boston Scientific, Natick, MA, USA) has a hydrophilic coating with a polymer-coated metal collar to facilitate device insertion and is only available in a 6-Fr size. The Heartrail system (Terumo, Tokyo, Japan) is available in 5-Fr, 6-Fr, and, 7-Fr sizes. The purpose of this study was to assess the feasibility and safety of the usage of the GuideLiner (GL) catheter (Vascular Solutions Inc., Minneapolis, MN, USA) extension system in complex PCI of CTO.Ī total of 130 CTO-PCI were performed in our center between 20. In this retrospective study, we analyzed the data of 18 patients (14%) in whom the GL was applied to facilitate CTO-PCI if an alternative technique such as an anchor balloon or a buddy wire was not possible. The procedures were performed by two high-volume operators. Indications for inclusion were angina pectoris and/or a positive functional ischemia test by magnetic resonance imaging or transthoracic echocardiography in the territory of the occluded artery of more than 10%. ![]() Antegrade and retrograde CTO techniques were considered, and the procedures were performed in a standardized manner. PCI procedures were performed via the femoral route. Procedural success was defined as recanalization of the CTO with a residual stenosis of 300 seconds).
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