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Guide extension catheter

Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Constantinos Andreou, Ioannis Karalis, Christos Maniotis, Johan W Jukema, Michael Koutouzis
Coronary stent delivery can be extremely challenging in tortuous and calcified lesions especially when radial approach is chosen. Guide extension catheter is a useful tool for overcoming the inherent difficulties arising by the use of radial access in complex percutaneous interventions. We describe a technique for guide extension catheter system advancement by presenting two cases. This was performed stepwise by repeated distal balloon anchoring in the coronary artery of interest.
August 8, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Michael J Plakke, Cory D Maxwell, Brandi A Bottiger
Surgical patients with pulmonary hypertension present a significant challenge to the anesthesiologist. Continuous perioperative monitoring of pulmonary artery (PA) pressure is recommended and most often accomplished with a PA catheter. Placement of a PA catheter may be difficult or contraindicated, and in these cases, transesophageal echocardiography is a useful alternative to monitor dynamic PA physiology. In this case, we used intraoperative transesophageal echocardiography to detect changes in peak PA pressure and guide clinical treatment in a patient with pulmonary hypertension and an extensive PA aneurysm undergoing partial nephrectomy...
September 1, 2016: A & A Case Reports
Kuan Leong Yew
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Hongbo Yang, Yuxiang Dai, Chenguang Li, Hao Lu, Shufu Chang, Juying Qian, Junbo Ge
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Mitsunari Matsumoto, Yusuke Tamanaha, Yoshimasa Tsurumaki, Tomohiro Nakamura
Cases in which an anomalous single coronary trunk arises from the ascending aorta are extremely rare. In percutaneous coronary intervention for the lesion of a coronary artery anomaly, several problems may occur, including selection of a guide catheter, insufficient backup force, and difficulties of stent delivery. The GuideLiner catheter, which is a coaxial guide extension having the advantage of rapid exchange, facilitates coronary intervention for complex lesions. We report a case of angina having a lesion in the left anterior descending artery of a single coronary trunk arising from the ascending aorta...
2016: Case Reports in Cardiology
Enrico Fabris, Mark W Kennedy, Carlo Di Mario, Gianfranco Sinagra, Vincent Roolvink, Jan Paul Ottervanger, Arnoud W J Van't Hof, Elvin Kedhi
Due to the aging population undergoing percutaneous coronary intervention (PCI), interventional cardiologists are confronted daily with treatment of lesions with complex anatomy. Despite improvements in stent devices and PCI techniques, these lesions remain a challenge in terms of procedural success. Guide-extensions (GE) are coaxial "mother and child" catheters employed to facilitate device delivery but they can be used in many different complex scenarios. A comprehensive review of the possible applications of GE and of the GuideLiner™ (GL), the most widely used GE device, is missing...
November 1, 2016: International Journal of Cardiology
Roberto Garbo, Jacopo A Oreglia, Gabriele L Gasparini
Coronary perforation (CP) is a rare but potentially lethal complication of percutaneous coronary intervention (PCI). Management of CP is mainly conditioned by the extension of coronary rupture and location of the perforation. Successful treatment is highly affected by the operator's familiarity with tools and dedicated techniques to achieve prompt sealing of the disruption. We describe a "Balloon-Microcatheter" technique that may allow fast, safe, and effective management of CP with a single ≥ 6 Fr guiding catheter...
July 29, 2016: Catheterization and Cardiovascular Interventions
Eiji Ichimoto, Joseph De Gregorio
Coronary artery bypass graft perforation during percutaneous coronary intervention is a rare complication. Perforation of a left internal mammary artery (LIMA) graft due to a guide catheter extension system has not been described. We report the successful deployment of a polytetrafluoroethylene (PTFE)-covered stent to seal the LIMA graft perforation due to the guide catheter extension system. Percutaneous coronary intervention was performed for a culprit lesion of the distal left circumflex via the LIMA graft...
June 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Auras R Atreya, Sonali Arora, Gregory Valania
Pulmonary artery catheters have been extensively used for hemodynamic assessment over the past several decades. We present a case that highlights the management of a known, but rare and catastrophic complication of pulmonary artery catheter based therapy. An elderly lady with acute decompensated heart failure, severe pulmonary hypertension, and atrial fibrillation on anticoagulation had a pulmonary artery catheter inserted for hemodynamic monitoring. Subsequently, the patient developed acute hemoptysis and damped pulmonary artery pressure waveforms during inflation of the catheter tip balloon...
June 9, 2016: Acute Cardiac Care
Yasuo Okumura, Ichiro Watanabe, Kazuki Iso, Koichi Nagashima, Kazumasa Sonoda, Naoko Sasaki, Rikitake Kogawa, Keiko Takahashi, Kimie Ohkubo, Toshiko Nakai, Shiro Nakahara, Yuuichi Hori, Atsushi Hirayama
BACKGROUND: The clinical utility of an automated lesion tagging module based on catheter stability information (VisiTag) with the CARTO system during atrial fibrillation (AF) ablation remains to be established. We investigated whether VisiTag-guided extensive encircling pulmonary vein isolation (EEPVI) produces durable lesions. METHODS: The study involved 54 patients undergoing EEPVI for paroxysmal AF. We performed EEPVI guided by the module-generated ablation tags, i...
June 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Takayuki Warisawa, Hisaaki Ishiguro, Akihiro Nakajima, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving the left anterior descending artery and the first-diagonal branch. The lesion was calcified with vessel tortuosity. Despite adequate lesion preparation using scoring balloon, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. The use of 6-in-7 guiding extension catheter would have required removal of wire from the diagonal branch. To avoid this situation, we down-sized the extension catheter to 5Fr, which was successful in delivering the stent without removal of the wire from diagonal branch...
June 9, 2016: Cardiovascular Intervention and Therapeutics
Georgios E Christakopoulos, Emmanouil Brilakis
No abstract text is available yet for this article.
May 2016: Anatolian Journal of Cardiology
Vasim Farooq, Patrick W Serruys, Ahmad H S Mustafa, Mamas A Mamas, Nadim Malik, Hafez A Alhous, Magdi El-Omar, Cara Hendry, Durgesh N Rana, David Shelton, Paul K Wright, Nadira Narine, Bernard Clarke, Bernard Keavney, Farzin Fath-Ordoubadi, Douglas G Fraser
AIMS: The inability to optimise stent expansion fully whilst simultaneously preventing distal embolisation during ST-elevation myocardial infarction (STEMI) remains a clinical conundrum. We aimed to describe a newly devised angiographic strategy of "forward" and "back" aspiration that leads to more complete thrombus removal and prevention of distal embolisation, to allow high-pressure post-dilatation of the implanted stent to be performed. METHODS AND RESULTS: Forward aspiration was conducted with a conventional aspiration thrombectomy catheter, with bail-out aspiration thrombectomy for angiographically persistent thrombus utilising the larger bore 6 Fr (0...
April 2016: EuroIntervention
Marouane Boukhris, Salvatore Azzarelli, Salvatore Davide Tomasello, Zied Ibn Elhadj, Francesco Marzà, Alfredo R Galassi
Regardless of the clinical setting, a good back-up represents one of the most important conditions to ensure guide wire and balloon advancement and stent delivery. As a "mother and child" system, the GuideLiner catheter (Vascular Solutions Inc., Minneapolis, MN, USA) provides an extension to the guide catheter with better coaxial alignment and stability. We report two didactic cases showing the usefulness of the GuideLiner device in everyday catheterization laboratory practice. The first case was a primary percutaneous coronary intervention (PCI) in a 71-year-old diabetic man admitted for inferior ST-elevation myocardial infarction, related to tight proximal stenosis in a dominant tortuous and calcified left circumflex...
October 27, 2015: Journal of Tehran Heart Center
Dariusz Ciecwierz, Maksymilian Mielczarek, Milosz Jaguszewski, Rafal Peksa, Marcin Gruchala
No abstract text is available yet for this article.
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Gang Yang, Bing Yang, Youquan Wei, Fengxiang Zhang, Weizhu Ju, Hongwu Chen, Mingfang Li, Kai Gu, Yazhou Lin, Benqi Wang, Kejiang Cao, Pipin Kojodjojo, Minglong Chen
BACKGROUND: The high incidence of postprocedural atrial tachycardia reduces the absolute arrhythmia-free success rate of extensive ablation strategies to treat nonparoxysmal atrial fibrillation (NPAF). We hypothesized that a strategy of targeting low-voltage zones and sites with abnormal electrograms during sinus rhythm (SR-AEs) in the left atrium after circumferential pulmonary vein isolation and cavotricuspid isthmus ablation in patients with NPAF is superior. METHODS AND RESULTS: A total of 86 consecutive patients with NPAF were enrolled in study group...
February 2016: Circulation. Arrhythmia and Electrophysiology
Sheldon M Singh, Andre d'Avila, Young-Hoon Kim, Arash Aryana, J Michael Mangrum, Gregory F Michaud, Srinivas R Dukkipati, Conor D Barrett, E Kevin Heist, Michael K Parides, Kevin E Thorpe, Vivek Y Reddy
AIMS: Complex fractionated atrial electrograms (CFAE) are targeted during persistent atrial fibrillation (AF) ablation. However, many CFAE sites are non-specific resulting in extensive ablation. Ibutilide has been shown to reduce left atrial surface area exhibiting CFAE. We hypothesized that ibutilide administration prior to CFAE ablation would identify sites critical for persistent AF maintenance allowing for improved procedural efficacy and long-term freedom from atrial arrhythmias...
May 21, 2016: European Heart Journal
Mohammad Alkhalil, Alison Smyth, Simon J Walsh, Conor McQuillan, Mark S Spence, Colum G Owens, Colm G Hanratty
OBJECTIVE: We sought to investigate the incidence of complications associated with V2 Guideliner, understand the mechanisms and evaluate the impact of alterations made to the V3 Guideliner. METHODS: Retrospective analysis of consecutive cases employing V2 Guideliner from two university teaching hospitals. Complications were identified, analysed and classified into major versus minor ones. To understand the potential anatomical mechanism of these complications, analysis of normal great vessel anatomy was undertaken in separate cohort of patients undergoing cardiac catheterisation via right radial approach...
2016: Open Heart
Robert Thomas Dale, Michael Metcalfe, Silvia Chang, Edward Jones, Peter Black
A 66-year-old man was referred for urological evaluation for an abnormal digital rectal exam (cT2a, subtle nodule at left base, 121 cc prostate) and an elevated prostate specific antigen (PSA) of 8.0 ng/ml. Subsequent 12-core transrectal ultrasound (TRUS)-guided biopsy revealed Gleason 3+4 adenocarcinoma in seven of 12 cores, including all six cores on the right side and one core at the left apex. No extraprostatic extension was identified. Post-biopsy, the patient developed urinary retention requiring a catheter, as well as an Escherichia coli (E...
November 2015: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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