![stent using a guideliner stent using a guideliner](https://blog.studentrdh.com/wp-content/uploads/2019/08/Coronary-artery-bypass-graft-768x768.jpg)
4 ), which also offered robust GC support, enabling direct stenting of the lesion with a 3×12-mm Promus stent ( Fig. Excellent visualization of the lesion was obtained following deep intubation of the left circumflex with a 6F GuideLiner ( Fig. A decision was taken to approach this lesion via the native circumflex, rather than via the graft, because of a 90° angle between the graft and the OM. The safety profile of the device has improved with successive generations and with increased operator experience. 2 ), it was poorly visualized via native vessel angiography due to competitive flow from the graft ( Fig. A helping hand: GuideLiner use to facilitate stent delivery The GuideLiner catheter system is a tool that can be used to increase procedural success in complex percutaneous coronary intervention. Although the lesion was well visualized via graft angiography ( Fig. Coronary and graft angiography demonstrated a lesion immediately distal to the anastomosis of a SVG with a large obtuse marginal branch (OM). We describe two cases of percutaneous coronary intervention (PCI) involving saphenous vein grafts (SVG) where use of a 6F GuideLiner facilitated the procedure by providing excellent GC support and superior target lesion visualization.Ī 52-year-old male presented with an acute coronary syndrome (ACS). A GuideLiner reduces the internal diameter of the ‘mother’ GC by approximately 1F size it is available in 6F, 7F, and 8F sizes. It has a 20-cm, highly flexible, super soft rapid exchange section which facilitates its insertion and allows the use of standard length guidewires, balloons, or stents through an existing haemostatic valve. 1 ) is a modified ‘child’ guide catheter (GC) which can be delivered through a standard GC, providing an extension for deep seating, added backup support, and coaxial alignment. Recently, several such catheters have become commercially available, including Terumo’s Heartrail II catheter and Vascular Solutions’ GuideLiner catheter. This double-coaxial catheter arrangement is often referred to as ‘mother and child’, with the outer GC being the ‘mother’ and the inner GC being the ‘child’. These limitations may be overcome by deeply intubating the proximal or mid segment of the target vessel with a smaller GC through the outer GC.
![stent using a guideliner stent using a guideliner](https://drbillsukala.com/wp-content/uploads/2021/03/angioplasty_stent-1-768x512.jpg)
In situations where percutaneous coronary intervention (PCI) is deemed necessary, such poor visualization may be compounded by poor guide catheter (GC) support, rendering intervention difficult or even impossible. Visualization of distal vessel run-off following contrast injection in a coronary artery or bypass graft may be poor due to suboptimal ‘seating’ of the catheter or to competitive antegrade or retrograde flow from native vessels.