![]() In this study, we characterized the procedural and angiographic characteristics of cases where GuideLiner use facilitated successful TRI. However, no prior study has examined the utility and predictors of GuideLiner use as an adjunctive tool for TRI. Early reports demonstrated successful application of this catheter extension for complex TF coronary interventions including vein and LITA grafts,. The GuideLiner catheter (Vascular Solutions, Minneapolis, MN) is a novel “mother and child” rapid exchange atraumatic guide catheter extension that allows deep vessel intubation with minimal trauma to the native coronary artery. With many new operators adopting radial catheterization and TRI, improved techniques to facilitate successful completion of the procedure could have significant advantages. More aggressive radial-specific guides can also be used, but these may also result in proximal vessel injury. However, most guide catheters are designed for support at the coronary ostia and such maneuvers can traumatize the target coronary artery. One technique to overcome lack of guide catheter support includes deep intubation of the guide catheter. Since most guide catheters were also designed for a TF approach, they may provide less backup support and coaxial alignment for TRI. As a result, less guide backup force is generated. Specifically, guide catheters advanced from the right radial artery often approach the coronary ostia from a vertical downward approach, which excludes the aortic arch. ĭuring trans-radial cardiac catheterization, the anatomic and geometric characteristics of the ascending aorta relative to the catheter differ significantly from TF angiography. Additionally, anatomic variations and lack of guide catheter support increase the technical complexity of TRI. Barriers to TRI include a steep initial learning curve and time required to gain proficiency at TRI. ![]() Although TRI is increasingly common, it currently represents < 10% of all PCIs in the USA. Deep intubation with the Guideliner facilitated delivery, allowed us to optimize stent apposition and also improved visualization of the vessel due to selective cannulation.Transradial coronary intervention (TRI) is associated with significantly reduced rates of bleeding and access site related complications compared to the transfemoral (TF) approach. We then passed a 6F GuideLiner into the vessel and by removing the proximal resistance we could then deliver the 3.0 mm stent, followed by a 4.0 mm stent and post-dilatation with a 4.0 mm balloon. Colm Hanratty, an interventional cardiologist at Belfast City Hospital in Belfast, Ireland, commented on one of his initial clinical uses of the GudieLiner: “In this patient, despite modification of the diseased segment and subsequent pre-dilatation, we could not track a 3.0 mm stent across the lesion due to significant friction in the proximal vessel. The GuideLiner is as easy to insert as a standard rapid exchange balloon catheter and has quickly become a routine part of my angioplasty practice.”ĭr. Furthermore, the soft and very flexible tip will often cross tortuous disease where a stent gets stuck, enabling delivery of stents and other equipment directly to the target lesion. Douglas Fraser, an Interventional cardiologist with Manchester Heart Centre in Manchester, United Kingdom, commented on his initial clinical experience with the GuideLiner: “Deep intubation of the Guideliner catheter within a soft 6F guide provides better backup support and is less traumatic than using stiff 7F and 8F guides that were previously required in complex disease. launch of the GuideLiner catheter expected to commence in November through Vascular Solutions’ direct sales force.ĭr. CE mark clearance of the GuideLiner was received and European sales and clinical uses commenced in October, with the U.S. The GuideLiner catheter will be available in 6, 7 and 8 French sizes as part of Vascular Solutions’ specialty catheter product line. The GuideLiner is a unique coaxial “mother and child” guide extension with rapid exchange convenience that provides back-up support and selective deep intubation in challenging coronary interventions. The device, designed to provide a coaxial guide extension and rapid exchange for coronary or peripheral interventions, comes in 6F, 7F, 8F (Freedom Fries) sizes and is delivered through standard guide catheters, hence it allows physicians to use “standard length guidewires, balloons or stents through an existing hemostatic valve,” according to the company. ![]() US FDA has given 510(k) regulatory clearance to Vascular Solutions Inc., a Minneapolis, Minnesota firm, to market the GuideLiner™ catheter. ![]()
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