Various companies have implemented guiding catheter extensions in their portfolio to overcome the problem of a poor backup support. 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. 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). 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. 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. In experienced hands, reopening rates exceed 85%. Due to new interventional techniques and the use of further advanced sophisticated materials, success rates of CTO recanalization increased steadily in recent years. A CTO of a coronary artery can be identified in up to 30% among patients with a clinical indication for coronary angiography.
All rights reserved.Recanalization of chronic total occlusions (CTO) remains a challenge in interventional cardiology. The device unsuccessful rate was less in the Guideplus, which may suggest the better performance as the guide extension catheter.Ĭhronic total occlusion Guide extension catheter Percutaneous coronary intervention.Ĭopyright © 2018 Elsevier Inc. The Guideplus was more frequently used to support the small profile balloon crossing the CTO or 99% stenosis. The purpose of guide extension catheter was significantly different between the Guideplus and GuideLiner. The device unsuccessful rate was significantly less in the Guideplus (8.7%) than in the GuideLiner (20.4%) (P = 0.022). The Guideplus was frequently used to support the small profile balloon crossing the CTO or 99% stenosis (20.7%), whereas the GuideLiner was not used (0%). The purpose of guide extension catheter was significantly different between the 2 groups (P < 0.001). Ninety-two lesions were classified as the Guideplus group, whereas 103 lesions were classified as the GuideLiner group. We classified the purpose of guide extension catheter into 4 categories: (1) to advance devices into the target lesion, (2) to engage guide catheter into the ostium, (3) to support the small profile balloon crossing the CTO or 99% stenosis that the microcatheter could not cross, and (4) others. We compared the purpose of guide extension catheter and the device unsuccessful rate between the Guideplus and GuideLiner. The aim of the present study was to compare device performance between the Guideplus and GuideLiner. Recently, the Guideplus (Nipro, Osaka, Japan) has emerged as a new guide extension catheter. The guide extension catheter is frequently used in current percutaneous coronary intervention, and the GuideLiner (Vascular Solutions Inc., Minneapolis, MN) has been the standard guide extension catheter.
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