Safety and Efficacy of Guidezilla Extension Catheter for the Percutaneous Treatment of Complex Coronary Lesions

Authors

  • Tao Chen Department of Cardiology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
  • Weihao Xu Department of Cardiology, The Second Medical Centre, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
  • Yulun Cai Department of Cardiology, The Second Medical Centre, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
  • Qi Wang Department of Cardiology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
  • Jun Guo Department of Cardiology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
  • Yundai Chen Department of Cardiology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China

DOI:

https://doi.org/10.1532/hsf.2709

Keywords:

GuidezillaTM, percutaneous coronary intervention, complex coronary lesions

Abstract

Background: The GuidezillaTM support extension catheter is designed to provide extra back-up support and efficient device delivery during complex percutaneous coronary interventions (PCIs), such as in treatment of severe calcification, tortuous chronic total occlusions (CTOs), and coronary anomalies. The aim of this study was to describe our initial experience with the GuidezillaTM extension catheter in the treatment of complex coronary artery lesions.

Methods: This study retrospectively analyzed data from 165 PCI cases that used the GuidezillaTM guide extension catheter between March 2015 and August 2017. We collected patient clinical characteristics, target lesion characteristics, and procedural details.

Results: Eighty-six percent of patients had complex Type C lesions, and 13.9% had Type B lesions. Lesion length ranged from 8 mm to 130 mm (≤ 20 mm, 15.4%; 20–40 mm, 35.8%; > 40 mm, 49.1%). The right coronary artery (59.2%) was the most common intervention vessel followed by the left ascending artery (30.6%) and the left circumflex artery (10.2%). CTO accounted for 38% of all lesions, followed by distortions (28%), heavy calcification (24%), proximal stent thrombosis (9%), and coronary artery origin anomalies (1%). A total of 142 patients underwent successful PCI using the GuidezillaTM extension catheter. The success rate was 86%.

Conclusion: The GuidezillaTM guide extension catheter was an effective and safe technique in the transradial treatment of complex coronary lesions. Use of the GuidezillaTM guide extension catheter can shorten the procedure time and ensure overall procedural success with a reduced complication rate in cases where adequate progress using angioplasty devices has not been achieved.

References

Chang YC, Fang HY, Chen TH, Wu CJ. 2013. Left main coronary artery bidirectional dissection caused by ejection of Guideliner catheter from the guiding catheter. Catheter Cardiovasc Interv 82:E215–20.

Cox N, Resnic FS, Popma JJ, Simon DI, Eisenhauer AC, Rogers C. 2004. Comparison of the risk of vascular complications associated with femoral and radial access coronary catheterization procedures in obese versus nonobese patients. Am J Cardiol 94:1174-7.

Cuneo A, Tebbe U. 2008. The management of chronic total coronary occlusions. Minerva Cardioangiol 56:527-41.

Di MC, Ramasami N. 2008. Techniques to enhance guide catheter support. Catheter Cardiovasc Interv 72:505-12.

Dursun H, Taştan A, Tanrıverdi Z, Özel E, Kaya D. 2016. GuideLiner catheter application in complex coronary lesions: experience of two centers. Anatol J Cardiol 16:333-9.

Garcíablas S, Núñez J, Mainar L, et al. 2015. Usefulness and Safety of a Guide Catheter Extension System for the Percutaneous Treatment of Complex Coronary Lesions by a Transradial Approach. Med Princ Pract 24:171-7.

Hildick-Smith DJ, Walsh JT, Lowe MD, Petch MC. 2010. Coronary angiography in the fully anticoagulated patient: The transradial route is successful and safe. Catheter Cardiovasc Interv 58:8-10.

Hou L, Wei YD, Li WM, Xu YW. 2010. Comparative study on transradial versus transfemoral approach for primary percutaneous coronary intervention in Chinese patients with acute myocardial infarction. Saudi Med J 31:158-62.

Hynes B, Dollard J, Murphy G, et al. 2011. Enhancing back-up support during difficult coronary stent delivery: single-center case series of experience with the Heartrail II catheter. J Invasive Cardiol 23:43-6.

Papayannis AC, Michael TT, Brilakis ES. 2012. Challenges associated with use of the GuideLiner catheter in percutaneous coronary interventions. J Invasive Cardiol 24:370-1.

Ramanathan PK, Redfern R. 2013. Use of guideliner catheter for anomalous right coronary artery angiography and intervention. J Invasive Cardiol 25:E20.

Roth C, Berger R, Scherzer S, et al. 2016. Comparison of magnetic wire navigation with the conventional wire technique for percutaneous coronary intervention of chronic total occlusions: a randomised, controlled study. Heart Vessels 31:1266-76.

Saeed B, Banerjee S, Brilakis ES. 2008. Percutaneous coronary intervention in tortuous coronary arteries: associated complications and strategies to improve success. J Interv Cardiol 21:504-11.

Tunuguntla A, Daneault B, Kirtane AJ. 2012. Novel use of the guideLiner catheter to minimize contrast use during PCI in a patient with chronic kidney disease. Catheter Cardiovasc Interv 80:453-5.

Waggoner T, Desai H, Sanghvi K. 2015. A unique complication of the GuideZilla guide extension support catheter and the risk of stent stripping in interventional & endovascular interventions. Indian Heart J 67:381-4.

Waterbury TM, Sorajja P, Bell MR, et al. 2016. Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention. Catheter Cardiovasc Interv 88:1057-65.

Yamane M. 2012. Current percutaneous recanalization of coronary chronic total occlusion. Rev Esp Cardiol (Engl Ed) 65:265-77.

Yew KL, Kang Z. 2015. Guidezilla guide extension catheter facilitated the delivery of long and bulky In. Pact Falcon drug-coated balloon for the treatment of chronic total occlusion lesion. Int J Cardiol 201:220-1.

Yew KL. 2016. Guidezilla guide extension catheter enhances the delivery of bioresorbable vascular scaffold in an anomalous coronary artery. Int J Cardiol 223:239-41.

Published

2020-03-17

How to Cite

Chen, T., Xu, W., Cai, Y., Wang, Q., Guo, J., & Chen, Y. (2020). Safety and Efficacy of Guidezilla Extension Catheter for the Percutaneous Treatment of Complex Coronary Lesions. The Heart Surgery Forum, 23(2), E147-E150. https://doi.org/10.1532/hsf.2709

Issue

Section

Articles