The GuideLiner may be a useful adjunct for rotablation when the rotating burr cannot cross a tight, calcified stenosis and more support is needed. It is prudent to avoid large burrs because of the risk of entrapment in the GuideLiner. VSIs GuideLiner catheter is a medical device used in coronary catheterization medical procedures to provide stable access to the coronary arteries and. Caution is needed to position the burr distal to the GuideLiner before starting any forward rotation to avoid potential damage and shear of the “child” catheter. However, its use to deliver the rotablation burr (3) is off-label and has been reported only once (4). The GuideLiner has been previously used to retrieve a trapped rotaburr (2). The GuideLiner is a guide catheter extension used for the “mother-and-child” technique, which improves support through deep intubation of the target vessel and thus facilitates delivery of stents in tortuous or calcified vessels (1). The PCI was completed with standard techniques, with excellent results ( Figure 1C). It was therefore decided to use the GuideLiner 6F catheter for selective intubation of the right coronary artery, which was positioned beside the crushed stent. This maneuver obviously “stiffened” the guide catheter-rotawire-rotablation catheter assembly and enabled the rotating burr to cross the heavily calcified stenosis. We eventually managed to rotablate the calcified stenosis after we advanced a 6-F GuideLiner (“mother-and-child” technique) (Vascular Solutions Inc., Minneapolis, Minnesota) proximal to the stenosis ( Figure 1B, Online Video 3). However, we were initially unable to cross the stenosis with the rotating 1.25-mm burr. We used a left femoral access, a long sheath, and an Amplatz Left 1 guide catheter (Boston Scientific, Natick, Massachusetts) to optimize support. Final result after right coronary artery stent deployment (left anterior oblique view) ( Online Video 3). (C) Right coronary angiogram post rotational atherectomy. Rotaburr crossing the lesion with the support of the GuideLiner (left anterior oblique view) ( Online Video 2). (B) Rotational atherectomy supported by the GuideLiner.
Tight calcified stenosis in the midportion of the right coronary artery (left anterior oblique view) ( Online Video 1). Vascular Solutions GuideLiner catheter V2, 6F (5-in-6), Required GuideCatheter I. (A) Right coronary angiogram pre-rotational atherectomy. GuideLiner-Facilitated Rotational Atherectomy in Calcified Right Coronary Artery GuideLiner V3 : The GuideLiner catheter is a single lumen rapid exchange catheter offered in sizes compatible with 6F,7F, and 8F guide catheters and may be placed over an exchange length.
Guideliner 6f download#
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