Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention

Thomas M. Waterbury, Paul Sorajja, Malcolm R. Bell, Ryan J. Lennon, Verghese Mathew, Mandeep Singh, Gurpreet S Sandhu, Rajiv Gulati

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives: To investigate the utility and safety of the GuideLiner "mother-and-child" catheter system during transradial and transfemoral percutaneous coronary intervention (PCI). Background: In patients with complex coronary anatomy, stent delivery can be challenging and result in procedural failure and complications. The GuideLiner is a coaxial guide extension system designed to enable deep vessel engagement and facilitate device delivery. The purpose of this study was to evaluate procedural success and safety in a series of GuideLiner-facilitated PCI. Methods: Single center retrospective study of PCI utilizing the GuideLiner catheter between February 2010 and October 2014. Patients who underwent PCI without GuideLiner use during the same time period were used as controls for comparison. Results: A total of 363 cases of GuideLiner-facilitated PCI were identified from 6,088 unique PCI procedures performed during this same time period. Patients in the GuideLiner group were older (mean age 71.5 vs. 67.8, P<0.001) and had more multivessel disease (72% vs. 63%, P=0.001) compared with controls. Type C lesions were present in 78% of GuideLiner cases. Procedural success resulting in successful device delivery with the GuideLiner catheter was 80.2%. Stent deformation associated with GuideLiner use occurred in 2.2% (8/363), with the incidence of this complication decreasing over device iterations. Coronary dissection attributed to GuideLiner occurred in 3.3% (12/363) and became less frequent over the study period. Conclusions: In this consecutive series of GuideLiner supported PCI, the guide extension system enabled procedural success in the majority. A decline in device-associated complications over time may be attributed to operator learning curve, patient selection, and improvement in catheter design.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
DOIs
StateAccepted/In press - 2015

Fingerprint

Percutaneous Coronary Intervention
Catheters
Equipment and Supplies
Stents
Safety
Learning Curve
Patient Selection
Dissection
Anatomy
Retrospective Studies
Mothers
Incidence

Keywords

  • Complex PCI
  • Interventional devices
  • PCI complications

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention. / Waterbury, Thomas M.; Sorajja, Paul; Bell, Malcolm R.; Lennon, Ryan J.; Mathew, Verghese; Singh, Mandeep; Sandhu, Gurpreet S; Gulati, Rajiv.

In: Catheterization and Cardiovascular Interventions, 2015.

Research output: Contribution to journalArticle

Waterbury, Thomas M. ; Sorajja, Paul ; Bell, Malcolm R. ; Lennon, Ryan J. ; Mathew, Verghese ; Singh, Mandeep ; Sandhu, Gurpreet S ; Gulati, Rajiv. / Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention. In: Catheterization and Cardiovascular Interventions. 2015.
@article{0e28d91a287d4d7c959bd493fc3cd785,
title = "Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention",
abstract = "Objectives: To investigate the utility and safety of the GuideLiner {"}mother-and-child{"} catheter system during transradial and transfemoral percutaneous coronary intervention (PCI). Background: In patients with complex coronary anatomy, stent delivery can be challenging and result in procedural failure and complications. The GuideLiner is a coaxial guide extension system designed to enable deep vessel engagement and facilitate device delivery. The purpose of this study was to evaluate procedural success and safety in a series of GuideLiner-facilitated PCI. Methods: Single center retrospective study of PCI utilizing the GuideLiner catheter between February 2010 and October 2014. Patients who underwent PCI without GuideLiner use during the same time period were used as controls for comparison. Results: A total of 363 cases of GuideLiner-facilitated PCI were identified from 6,088 unique PCI procedures performed during this same time period. Patients in the GuideLiner group were older (mean age 71.5 vs. 67.8, P<0.001) and had more multivessel disease (72{\%} vs. 63{\%}, P=0.001) compared with controls. Type C lesions were present in 78{\%} of GuideLiner cases. Procedural success resulting in successful device delivery with the GuideLiner catheter was 80.2{\%}. Stent deformation associated with GuideLiner use occurred in 2.2{\%} (8/363), with the incidence of this complication decreasing over device iterations. Coronary dissection attributed to GuideLiner occurred in 3.3{\%} (12/363) and became less frequent over the study period. Conclusions: In this consecutive series of GuideLiner supported PCI, the guide extension system enabled procedural success in the majority. A decline in device-associated complications over time may be attributed to operator learning curve, patient selection, and improvement in catheter design.",
keywords = "Complex PCI, Interventional devices, PCI complications",
author = "Waterbury, {Thomas M.} and Paul Sorajja and Bell, {Malcolm R.} and Lennon, {Ryan J.} and Verghese Mathew and Mandeep Singh and Sandhu, {Gurpreet S} and Rajiv Gulati",
year = "2015",
doi = "10.1002/ccd.26329",
language = "English (US)",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention

AU - Waterbury, Thomas M.

AU - Sorajja, Paul

AU - Bell, Malcolm R.

AU - Lennon, Ryan J.

AU - Mathew, Verghese

AU - Singh, Mandeep

AU - Sandhu, Gurpreet S

AU - Gulati, Rajiv

PY - 2015

Y1 - 2015

N2 - Objectives: To investigate the utility and safety of the GuideLiner "mother-and-child" catheter system during transradial and transfemoral percutaneous coronary intervention (PCI). Background: In patients with complex coronary anatomy, stent delivery can be challenging and result in procedural failure and complications. The GuideLiner is a coaxial guide extension system designed to enable deep vessel engagement and facilitate device delivery. The purpose of this study was to evaluate procedural success and safety in a series of GuideLiner-facilitated PCI. Methods: Single center retrospective study of PCI utilizing the GuideLiner catheter between February 2010 and October 2014. Patients who underwent PCI without GuideLiner use during the same time period were used as controls for comparison. Results: A total of 363 cases of GuideLiner-facilitated PCI were identified from 6,088 unique PCI procedures performed during this same time period. Patients in the GuideLiner group were older (mean age 71.5 vs. 67.8, P<0.001) and had more multivessel disease (72% vs. 63%, P=0.001) compared with controls. Type C lesions were present in 78% of GuideLiner cases. Procedural success resulting in successful device delivery with the GuideLiner catheter was 80.2%. Stent deformation associated with GuideLiner use occurred in 2.2% (8/363), with the incidence of this complication decreasing over device iterations. Coronary dissection attributed to GuideLiner occurred in 3.3% (12/363) and became less frequent over the study period. Conclusions: In this consecutive series of GuideLiner supported PCI, the guide extension system enabled procedural success in the majority. A decline in device-associated complications over time may be attributed to operator learning curve, patient selection, and improvement in catheter design.

AB - Objectives: To investigate the utility and safety of the GuideLiner "mother-and-child" catheter system during transradial and transfemoral percutaneous coronary intervention (PCI). Background: In patients with complex coronary anatomy, stent delivery can be challenging and result in procedural failure and complications. The GuideLiner is a coaxial guide extension system designed to enable deep vessel engagement and facilitate device delivery. The purpose of this study was to evaluate procedural success and safety in a series of GuideLiner-facilitated PCI. Methods: Single center retrospective study of PCI utilizing the GuideLiner catheter between February 2010 and October 2014. Patients who underwent PCI without GuideLiner use during the same time period were used as controls for comparison. Results: A total of 363 cases of GuideLiner-facilitated PCI were identified from 6,088 unique PCI procedures performed during this same time period. Patients in the GuideLiner group were older (mean age 71.5 vs. 67.8, P<0.001) and had more multivessel disease (72% vs. 63%, P=0.001) compared with controls. Type C lesions were present in 78% of GuideLiner cases. Procedural success resulting in successful device delivery with the GuideLiner catheter was 80.2%. Stent deformation associated with GuideLiner use occurred in 2.2% (8/363), with the incidence of this complication decreasing over device iterations. Coronary dissection attributed to GuideLiner occurred in 3.3% (12/363) and became less frequent over the study period. Conclusions: In this consecutive series of GuideLiner supported PCI, the guide extension system enabled procedural success in the majority. A decline in device-associated complications over time may be attributed to operator learning curve, patient selection, and improvement in catheter design.

KW - Complex PCI

KW - Interventional devices

KW - PCI complications

UR - http://www.scopus.com/inward/record.url?scp=84983095155&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84983095155&partnerID=8YFLogxK

U2 - 10.1002/ccd.26329

DO - 10.1002/ccd.26329

M3 - Article

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

ER -