Kumar Sanjay, Gorog Diana A, Secco Gioel G, Di Mario Carlo, Kukreja Neville
Department of Cardiology, East and North Hertfordshire NHS Trust, Stevenage SG1 4AB, Hertfordshire, United Kingdom.
J Invasive Cardiol. 2010 Oct;22(10):495-8.
The failure to deliver a stent across the target lesion during percutaneous coronary intervention, especially in arteries with calcified tortuous anatomy, is often due to insufficient back-up support from the guiding catheter. Deep-vessel intubation with the guiding catheter may overcome this problem, but risks coronary dissection. The Heartrail II (Terumo, Japan) "five-in-six catheter system" (or "mother-and-child" catheter) comprises a flexible-tipped long 5 Fr catheter advanced through a standard 6 Fr guiding catheter to deeply intubate the target vessel, thus providing enough back-up support to enable stent delivery. Here we describe a newly developed "child" support catheter (The GuideLiner; Vascular Solutions, Inc., Minneapolis, Minnesota), report its successful use in a series of 4 difficult cases and discuss practical tips to optimize its performance.
