![]() ![]() Methods: A physician-initiated, observational study conducted at a tertiary care centre in India between July 2021 and July 2022. 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. Except for this one case, extension catheter-related complications were not observed.Ī guide extension catheter can be used safely in BPA procedures with anatomically complex pulmonary artery branches and complex lesions by increasing backup support. Only one case of pulmonary artery dissection using a guide extension catheter was reported. Regarding safety concerns, complications were observed in 5 of 55 sessions (9.1%) and 6 of 91 lesions (6.6%). Complex lesions had a lower success rate than simple lesions (p = 0.04). Procedural success was achieved in 92.7% of 55 sessions and in 95.6% of 91 lesions. Regarding the intended use, a guide extension catheter was used to strengthen the backup force of the guiding catheter in 52% of cases, extend the tip of the catheter in 38% of cases, and maintain the coaxiality of the guiding catheter in 10% of cases. The efficacy of the guide extension catheter was assessed based on the success of the procedures and safety was evaluated based on procedure-related complications. The purpose (backup, coaxial, and extension), efficacy, and safety of the guide extension catheters were explored. We retrospectively analyzed 91 lesions in 55 sessions of 28 patients with CTEPH who underwent BPA using a guide extension catheter. However, the effectiveness and safety of guide extension catheters for BPA treatment in patients with CTEPH have not been demonstrated. It can be recommended as an important additional tool in advanced interventional cardiology such as antegrade and retrograde CTO-PCI if other techniques like anchor balloon or anchor wire are not possible.īalloon pulmonary angioplasty (BPA) is used for treatment of inoperable chronic thromboembolic pulmonary hypertension (CTEPH) and residual pulmonary hypertension after pulmonary endarterectomy (PEA) to improve hemodynamics, right ventricular function, and exercise capacity. Its use is indicated in cases in which back-up force needs to be strengthened to pass a CTO despite advanced calcification. ![]() The GL catheter is an adjunctive interventional device which enhances and amplifies CTO-PCI. The overall success rate was 88.9 ± 0.32% there were no relevant complications. All procedures were performed femorally the retrograde approach was used in 27.8 ± 0.46% of cases. The Japanese CTO score reflecting lesion complexity was 3.56 ± 0.78. The GL is a coaxial, monorail guiding catheter extension delivered through a standard guiding catheter and is available in different sizes.Īlmost all lesions were classified as severely calcified (94.4 ± 0.24%). We examined 18 patients and used the GL catheter to overcome poor support and excessive friction in standardized antegrade and retrograde CTO procedures. The purpose of this study was to assess the feasibility of the GuideLiner (GL) catheter use. Failure of delivering a stent or a balloon across the target lesion during percutaneous coronary intervention (PCI) of chronic total occlusion (CTO), especially in arteries with calcified tortuous anatomy, is often due to insufficient backup support from the guiding catheter.
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