Author + information
- Mohamed Ali,
- Hatim Yagoub,
- Alice Brennan,
- Donal Cahill,
- Samer Arnous,
- Terence Hennessy,
- Brendan Meany,
- Brian Hynes and
- Thomas Kiernan
Background: The GuideLiner (GL) is a 25 cm guide extension connected to a rapid-exchange push rod by collar transition. It is used primarily in complex percutaneous coronary intervention (PCI)for extra support, selective contrast delivery but primarily for protected distal stent delivery and deployment.
This registry Of University Hospital Limerick (UHL) recorded 118 consecutive cases of Guideliner facilitated PCI to assess safety, feasibility and use of “anchor-balloon technique” in terms of distal stent delivery.
Methods: The study was conducted at (UHL), Ireland. Clinical and angiographic records were searched using administrative and clinical databases at (UHL) to identify all patients that underwent GL assisted PCI with the indication of facilitating stent delivery and deployment at our institution from August 1, 2012, to July 1, 2016. All other cases involving use of GL for reasons such as contrast delivery or thrombectomy were excluded.
Results: Among 118 patients studied, median age was 69 years. Clinical indication for PCI was stable Angina in 60%(70/118) and acute coronary syndrome in 40%(48/118). It was predominantly Trans-radial intervention 63%(74/118) compared to 37% (44/118) trans-femoral. Most of the lesions were complex and had American Heart Association/American College of Cardiology (AHA/ACC) classification of B or C; (93%). The primary indication in all cases was to facilitate stent delivery. The use of the “anchor-balloon technique” to facilitate deep intubation and stent delivery was used in 25% (29/118). Device success rate was 86% (101/118). There were six cases of edge dissection all of which were stented successfully. in addition to two cases where the stents were damaged at the transition zone.
Conclusions: This is a large registry for the use of GL to facilitate difficult PCI. GL use resulted in increased back-up and guide catheter alignment for stent delivery in unfavorable tortuous coronary anatomies and complex, heavily calcified, and often distally located lesions, which otherwise may have been considered unsuitable for PCI. Procedural success rate was high, especially when anchor balloon is used, and apart from few minor complications the device was otherwise safe.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Intervention in Interventional Cardiology: Advanced Device Use
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1155-165
- 2017 American College of Cardiology Foundation