Other indications are less common, but can be equally useful, such as the engagement of the anomalous origin of a coronary artery, treatment of lesions through aortocoronary grafts, selective contrast injection or the treatment of distal lesions in ectatic arteries. Our data showed that this technique is mainly applicable to mid or distal lesions in arteries (in 15 of 16 cases) with relatively preserved proximal segments that can safely accommodate the catheter extension. The growing complexity of coronary lesions treated percutaneously makes this type of guide catheter extension a useful tool for an increasing number of cases in daily clinical practice. Both proximal vessel angulation and lesion angle have been identified as independent predictors for GuideLiner use. In the Twente registry, 97% of the lesions were type B2 or C in the American Heart Association/American College of Cardiology (AHA/ACC) classification. This problem occurs mainly in complex calcified lesions or tortuous arteries, as reflected in the type of lesions treated in our series. The most common indication for GuideLiner use is the difficulty or inability to place a stent or balloon in a complex coronary lesion. Only one minor complication was recorded. GuideLiner was particularly helpful when using the transradial approach. Conclusion: Use of the GuideLiner was an effective and safe technique for the percutaneous treatment of complex coronary lesions in which the adequate progress of angioplasty devices had failed. A type B dissection of a proximal left circumflex artery was the only periprocedural complication. Unsuccessful cases were a chronic total occlusion and a diffusely diseased left anterior descendant artery. Results: Of the 16 angiographic procedures, 14 (87.5%) were successful (stent deployment in 13 cases and a drug-eluting balloon in 1 case). The indication for the use of GuideLiner was a difficulty to advance and properly position a stent through a tortuous and/or calcified artery despite using high-support guide catheters or other useful techniques. Sixteen consecutive procedures (in 15 patients 12 males and 3 females) were evaluated. The indication for its use, efficacy and periprocedural complications were determined. The transradial approach was used in all cases. Materials and Methods: The clinical, angiographic and procedural data of percutaneous coronary interventions where GuideLiner was used during 2013 were collected. Objective: The aim of this study was to describe our initial experience with the GuideLinerĀ® catheter (Vascular Solutions Inc.) in the transradial treatment of complex lesions.
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