We prospectively recorded patient and procedural details, technical success, and in-hospital outcome of 65 consecutive patients undergoing "5-in-6" Fr GL-facilitated PCI of 70 target vessels. We aimed to assess feasibility and safety of GL-use in routine clinical practice. The GuideLiner™ (GL) (Vascular Solutions Inc., Minneapolis, MN, USA) is a guide catheter extension system that provides active back-up support by deep coronary intubation. Optimal ostial seating and adequate back-up of guide catheters are required for challenging percutaneous coronary interventions (PCI). Moreover, the aim of this article is to help interventional cardiologists using the device in difficult lesions to avoid potential complications. We describe here our experience with the Guideliner catheter for stent delivery and backup support we discuss its utility and drawbacks in acute and stable clinical settings. In our experience, the Guideliner catheter is safe to use and helps device delivery in difficult settings. In 2 cases, we had stent damage due to the passage of the stent through the Guideliner metal collar. Three proximal dissections were detected and sealed with stent implantation. The other 9 cases were performed successfully. One case, the first one, failed, as stent could not be delivered to the target lesion. In 2 cases PTCA with drug-eluting balloon was performed in the other cases second-generation drug-eluting stent was implanted. In 3 cases the operator chose the femoral access, in 2 cases crossover from radial to femoral access was needed, and the other cases were performed radially. Recently, a new support rapid exchange catheter, the Guideliner, has been designed specifically for device delivery.įrom June 2010 to December 2010, we performed 10 cases using the Guideliner catheter to improve backup support and facilitate stent delivery: 2 emergent PCI for ST elevation myocardial infarction, and 8 stable elective PCI. Stent delivery in complex coronary anatomy with severe calcification and tortuosity is still a common cause of percutaneous coronary interventions (PCI) failure.
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