Guidezilla extension catheter for percutaneous interventional therapy of complex lesions via a transradial approach: Case series from a single-center experience
Abstract
Background: Guide catheter extension systems have become one of the most powerful tools for addressing complex lesions during percutaneous coronary intervention (PCI), but data on a new-generation rapid exchange extension catheter — the Guidezilla catheter — are limited. Summarized herein reports on experience using the Guidezilla catheter for complex coronary lesions via a transradial approach at the documented institution an evaluation of its safety and efficacy.
Methods: A total of 25 patients (19 males and 6 females) who underwent PCI via the radial approach with the Guidezilla catheter for adequate back-up support and to facilitate equipment delivery were enrolled. The clinical, angiographic and procedural data of all 26 procedures in 25 patients (1 patient underwent two PCI procedures on different lesions) were collected to evaluate the safety and efficacy of this novel equipment.
Results: The mean age of the enrolled patients was 67.7 ± 8.41 years old. The mean depth of intubation was 27.90 ± 12.23 mm. Stent implantation was successful in 23 out of 26 procedures (88.5%) and failed in 3 cases: 1 case of tortuosity and severe angulation in a chronic total occlusion lesion; 1 case of an existing type B dissection (NHLBI classification system for coronary artery dissection types); and 1 case in which a stent was stripped off its balloon. None of the patients experienced coronary dissection, perforation, air embolism, pressure dampening or other major complications during the procedure.
Conclusions: The Guidezilla extension catheter is an effective and safe tool that provides improved back-up support and increases the success rate of PCI for complex coronary lesion by radial access.
Keywords: extension catheterGuidezillapercutaneous coronary interventiontransradialsafety and efficacy
References
- Burzotta F, Trani C, Mazzari MA, et al. Use of a second buddy wire during percutaneous coronary interventions: a simple solution for some challenging situations. J Invasive Cardiol. 2005; 17(3): 171–174.
- Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011; 377(9775): 1409–1420.
- Mahmood A, Banerjee S, Brilakis ES. Applications of the distal anchoring technique in coronary and peripheral interventions. J Invasive Cardiol. 2011; 23(7): 291–294.
- Von Sohsten R, Oz R, Marone G, et al. Deep Intubation of 6 French Guiding Catheters for Transradial Coronary Interventions. J Invasive Cardiol. 1998; 10(4): 198–202.
- Duong T, Christopoulos G, Luna M, et al. Frequency, Indications, and Outcomes of Guide Catheter Extension Use in Percutaneous Coronary Intervention. J Invasive Cardiol. 2015; 27(10): E211–E215.
- Dursun H, Taştan A, Tanrıverdi Z, et al. GuideLiner catheter application in complex coronary lesions: experience of two centers. Anatol J Cardiol. 2016; 16(5): 333–339.
- García-Blas S, Núñez J, Mainar L, et al. Usefulness and safety of a guide catheter extension system for the percutaneous treatment of complex coronary lesions by a transradial approach. Med Princ Pract. 2015; 24(2): 171–177.
- Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation. 1988; 78(2): 486–502.
- Turgut O, Yilmaz A, Yalta K, et al. Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation? Int J Cardiovasc Imaging. 2007; 23(6): 671–677.
- Zaacks SM, Allen JE, Calvin JE, et al. Value of the American College of Cardiology/American Heart Association stenosis morphology classification for coronary interventions in the late 1990s. Am J Cardiol. 1998; 82(1): 43–49.
- Ikari Y, Masuda N, Matsukage T, et al. Backup force of guiding catheters for the right coronary artery in transfemoral and transradial interventions. J Invasive Cardiol. 2009; 21(11): 570–574.
- Fabris E, Kennedy MW, Di Mario C, et al. Guide extension, unmissable tool in the armamentarium of modern interventional cardiology. A comprehensive review. Int J Cardiol. 2016; 222: 141–147.
- Kovacic JC, Sharma AB, Roy S, et al. GuideLiner mother-and-child guide catheter extension: a simple adjunctive tool in PCI for balloon uncrossable chronic total occlusions. J Interv Cardiol. 2013; 26(4): 343–350.
- Mozid AM, Davies JR, Spratt JC. The utility of a guideliner™ catheter in retrograde percutaneous coronary intervention of a chronic total occlusion with reverse cart-the "capture" technique. Catheter Cardiovasc Interv. 2014; 83(6): 929–932.
- Singh S, Singh M, Grewal N, et al. Transradial vs transfemoral percutaneous coronary intervention in ST-segment elevation myocardial infarction: a systemic review and meta-analysis. Can J Cardiol. 2016; 32(6): 777–790.
- Farooq V, Serruys PW, Mustafa AHS, et al. Forward and back aspiration during ST-elevation myocardial infarction: a feasibility study. EuroIntervention. 2016; 11(14): e1639–e1648.
- Farooq V, Mamas MA, Fath-Ordoubadi F, et al. The use of a guide catheter extension system as an aid during transradial percutaneous coronary intervention of coronary artery bypass grafts. Catheter Cardiovasc Interv. 2011; 78(6): 847–863.
- Ramanathan PK, Redfern R. Use of guideliner catheter for anomalous right coronary artery angiography and intervention. J Invasive Cardiol. 2013; 25(1): E20–E22.
- Pershad A, Sein V, Laufer N. GuideLiner catheter facilitated PCI--a novel device with multiple applications. J Invasive Cardiol. 2011; 23(11): E254–E259.
- Yew KL. Guidezilla guide extension catheter enhances the delivery of bioresorbable vascular scaffold in an anomalous coronary artery. Int J Cardiol. 2016; 223: 239–241.
- Waggoner T, Desai H, Sanghvi K. A unique complication of the GuideZilla guide extension support catheter and the risk of stent stripping in interventional & endovascular interventions. Indian Heart J. 2015; 67(4): 381–384.
- Waterbury TM, Sorajja P, Bell MR, et al. Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention. Catheter Cardiovasc Interv. 2016; 88(7): 1057–1065.
- Luna M, Papayannis A, Holper EM, et al. Transfemoral use of the GuideLiner catheter in complex coronary and bypass graft interventions. Catheter Cardiovasc Interv. 2012; 80(3): 437–446.
