Usefulness and safety of the GuideLiner catheter to enhance intubation and support of guide catheters: insights from the Twente GuideLiner registry
Usefulness and safety of the GuideLiner catheter to enhance intubation and support of guide catheters: insights from the Twente GuideLiner registry
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DOI：
10.4244/eijv8i3a52
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发表时间：
2012-07-01
期刊：
影响因子：
6.2
通讯作者：
von Birgelen, Clemens
中科院分区：
文献类型：
--
作者：
de Man, Frits H. A. F.;Tandjung, Kenneth;von Birgelen, Clemens
目的：对于具有挑战性的经皮冠状动脉介入治疗（PCI），需要最佳开口位置和充分的导引导管备用。GuideLinerTM（GL）（Vascular Solutions Inc.，Minneapolis，MN，USA）是一种导引导管延长系统，通过深冠状动脉插管提供主动备份支持。我们的目的是评估的可行性和安全性的GL-使用在常规的临床practice.Methods和结果：我们前瞻性地记录了患者和程序的细节，技术成功，并在医院的结果，65例连续进行“5-在-6”Fr GL-促进PCI的70个目标vessels。GL主要用于复杂冠状动脉病变的PCI：97%（68/70）为美国心脏协会/美国心脏病学会（AHA/ACC）B2/C型病变; 53%（37/70）位于远端; 23%（17/70）为重度钙化。适应症为增加导引导管的备用并促进支架输送（59%; 41/70）、实现导引导管的同轴对准（29%; 20/70）和选择性造影剂注射（13%; 9/70）。器械成功率为93%（65/70）。有没有重大并发症和两个轻微的并发症管理没有临床后遗症：一个空气栓塞和一个支架dislocation.Conclusions：GL-使用导致增加备份和引导导管对准支架输送在不利的曲折冠状动脉解剖结构和复杂，严重钙化，往往位于远端病变，否则可能被认为是不适合PCI。手术成功率高，无严重并发症。
Aims: Optimal ostial seating and adequate back-up of guide catheters are required for challenging percutaneous coronary interventions (PCI). The GuideLiner (TM) (GL) (Vascular Solutions Inc., Minneapolis, MN, USA) is a guide catheter extension system that provides active back-up support by deep coronary intubation. We aimed to assess feasibility and safety of GL-use in routine clinical practice.Methods and results: We prospectively recorded patient and procedural details, technical success, and in-hospital outcome of 65 consecutive patients undergoing "5-in-6" Fr GL-facilitated PCI of 70 target vessels. The GL was mainly used for PCI of complex coronary lesions: 97% (68/70) had American Heart Association/American College of Cardiology (AHA/ACC) lesion types B2/C; 53% (37/70) were distally located; and 23% (17/70) were heavily calcified. Indications were to increase back-up of the guide and facilitate stent delivery (59%; 41/70), achievement of coaxial alignment of the guide catheter (29%; 20/70), and selective contrast injections (13%; 9/70). Device success rate was 93% (65/70). There were no major complications and two minor complications managed without clinical sequelae: one air embolism and one stent dislodgement.Conclusions: GL-use resulted in increased back-up and guide catheter alignment for stent delivery in unfavourable 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 and there were no major complications.