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Akima T, Sakurai Y, Nakajima K, Koyama T. The Null technique as a novel, potential first-line method of device delivery for complicated lesions during percutaneous coronary intervention. IJC HEART & VASCULATURE 2023; 47:101241. [PMID: 37576084 PMCID: PMC10422662 DOI: 10.1016/j.ijcha.2023.101241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/30/2023] [Accepted: 06/19/2023] [Indexed: 08/15/2023]
Abstract
Aim During percutaneous coronary intervention (PCI), complicated lesions in the target coronary artery often hinder device delivery. Fluid lubricants have commonly been used to reduce friction between adjacent solid materials in manufacturing, thus achieving smoother action. This ex vivo experimental study examined whether a contrast medium could function as a fluid lubricant during PCI. Methods and results We used two different coronary artery lesion models with distinct complexities made from silicon. Each model was fit into the ex vivo PCI-simulation system. This ex vivo laboratory equipment consisted of ordinary PCI instruments and an aorta model from the Valsalva sinus to the descending aorta. A Wolverine™ cutting balloon catheter was advanced through each lesion model via a guide catheter set into the system. The maximum force required to push the catheter through the lesion models was measured while the vessel system was filled with either normal saline or contrast medium. The maximum force required was significantly lower with the contrast medium (1.38 ± 0.21 N in the normal-saline condition vs. 0.92 ± 0.05 N in the contrast-medium condition in the lesion model A, p < 0.001; 1.30 ± 0.07 N in the normal-saline condition vs. 1.14 ± 0.04 N in the contrast-medium condition in the lesion model B, p < 0.001). Conclusions The contrast medium for vessel system filling reduced the force required to push the devices through the lesion models. This contrast medium represents a potential candidate for a liquid lubricant to facilitate device delivery for complicated coronary lesions.
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Affiliation(s)
- Takashi Akima
- Department of Internal Medicine, Saitama Municipal Hospital, Saitama, Japan
- Department of Cardiology, Saitama Municipal Hospital, Saitama, Japan
| | - Yasuo Sakurai
- Division of Mechanical Engineering, Ashikaga College, Tochigi, Japan
| | - Kazuaki Nakajima
- Department of Internal Medicine, Saitama Municipal Hospital, Saitama, Japan
| | - Takashi Koyama
- Department of Internal Medicine, Saitama Municipal Hospital, Saitama, Japan
- Department of Cardiology, Saitama Municipal Hospital, Saitama, Japan
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Unzué L, Barrio P, García E, Mestre RT, Rodríguez Rodrigo FJ, Parra FJ. Percutaneous Intervention With GuideLiner Catheter in 4 Patients With Anomalous Coronary Artery Originating From Opposite Sinus of Valsalva. Tex Heart Inst J 2022; 49:484539. [PMID: 35930342 DOI: 10.14503/thij-20-7466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Percutaneous intervention in anomalous coronary arteries originating from the opposite sinus of Valsalva is complicated by their unusual location and course, which makes selective cannulation difficult. The GuideLiner (Vascular Solutions, Inc.) is a monorail guide extension catheter designed to advance beyond the tip of a mother guide catheter to enable deep intubation of a coronary artery, provide extra support, and improve coaxial alignment. We describe the cases of 4 patients with an anomalous coronary artery originating from the opposite sinus of Valsalva-including 2 with acute myocardial infarction-who underwent successful percutaneous coronary intervention with use of a GuideLiner catheter.
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Affiliation(s)
- Leire Unzué
- Interventional Cardiology Unit, HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), Hospital Universitario HM Montepríncipe, HM Hospitales, Madrid, Spain
| | - Patricia Barrio
- Cardiac Image Unit, HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Eulogio García
- Interventional Cardiology Unit, HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), Hospital Universitario HM Montepríncipe, HM Hospitales, Madrid, Spain
| | - Rodrigo Teijeiro Mestre
- Interventional Cardiology Unit, HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), Hospital Universitario HM Montepríncipe, HM Hospitales, Madrid, Spain
| | | | - Francisco Javier Parra
- Clinical Cardiology Unit, HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), HM Hospitales, Madrid, Spain
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Yamamoto W, Otsuji S, Takiuchi S, Kakishita M, Shimatani Y, Hasegawa K, Ishibuchi K, Tamaru H, Ishii R, Yasuda S, Taniguchi Y, Nakabayashi S, Kusumoto H, Higashino Y. Successful percutaneous removal of dislodged ring-marker of optical coherence tomography catheter using the twisted wire technique with a guide-extension catheter: A case report. J Cardiol Cases 2020; 22:242-245. [PMID: 33133319 DOI: 10.1016/j.jccase.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/06/2020] [Accepted: 06/26/2020] [Indexed: 11/25/2022] Open
Abstract
An 81-year-old male with diabetes and hypertension was admitted to our hospital due to chest pain on exertion. Coronary angiography revealed a severe stenosis at the middle of right coronary artery (RCA). We performed percutaneous coronary intervention under the guidance of optical coherence tomography (OCT) to the lesion in the middle RCA. After balloon dilations, a drug-eluting stent was deployed to the lesion. Then, OCT examination was performed. At that time, fluoroscopy revealed a foreign body over the 0.014-inch guidewire in the distal RCA, which was the ring-marker of OCT catheter. As RCA blood flow was well preserved, percutaneous removal of the dislodged ring-marker was immediately attempted. At first, we tried to remove the dislodged ring-marker with the guide-extension catheter trapping technique. However, it failed and advanced balloon catheter made the dislodged ring-marker migrate more distally. Therefore, we tried the twisted wire technique with the guide-extension catheter and finally the dislodged ring-marker was removed with it. To the best of our knowledge, this is the first case report of a successful percutaneous removal of a dislodged ring-marker of OCT catheter using the twisted wire technique with a guide-extension catheter. <Learning objective: Although intravascular foreign bodies during percutaneous coronary intervention (PCI) are very rare, it is one of the challenging complications. In this case, we experienced the dislodgement of ring-marker of optical coherence tomography catheter which was removed by twisted wire technique with a guide-extension catheter. The twisted wire technique with a guide-extension catheter can be a useful approach for percutaneous removal of foreign bodies, when other percutaneous retrieval techniques are unsuitable.>.
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Affiliation(s)
- Wataru Yamamoto
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Satoru Otsuji
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Shin Takiuchi
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Mikio Kakishita
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Yuji Shimatani
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Katsuyuki Hasegawa
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Kasumi Ishibuchi
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Hiroto Tamaru
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Rui Ishii
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Shingo Yasuda
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Yusuke Taniguchi
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Sho Nakabayashi
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Hirofumi Kusumoto
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
| | - Yorihiko Higashino
- Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
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Young L, Harb SC, Puri R, Khatri J. Percutaneous coronary intervention of an anomalous coronary chronic total occlusion: The added value of three-dimensional printing. Catheter Cardiovasc Interv 2020; 96:330-335. [PMID: 32233062 DOI: 10.1002/ccd.28625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/02/2019] [Accepted: 11/16/2019] [Indexed: 11/07/2022]
Abstract
Three-dimensional (3D) printing has had an evolving role in cardiology, although has been largely reserved for planning of structural heart disease interventions. We present a case whereby multimodality imaging, including 3D printing, played a pivotal role in planning a technically feasible approach for complex percutaneous coronary intervention of a chronically occluded anomalous right coronary artery, with creation of a customized guide catheter.
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Affiliation(s)
- Laura Young
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Serge C Harb
- Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rishi Puri
- Department of Cardiovascular Intervention, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jaikirshan Khatri
- Department of Cardiovascular Intervention, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
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Bharadwaj AS, Bhatheja S, Sharma SK, Kini AS. Utility of the guideliner catheter for percutaneous coronary interventions in patients with prior transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2017; 91:271-276. [DOI: 10.1002/ccd.27211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/24/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Aditya S. Bharadwaj
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai; New York
| | - Samit Bhatheja
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai; New York
| | - Samin K. Sharma
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai; New York
| | - Annapoorna S. Kini
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai; New York
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Sugimoto T, Nomura T, Hori Y, Yoshioka K, Kubota H, Miyawaki D, Urata R, Kikai M, Keira N, Tatsumi T. Guide Catheter Extension Device Is Effective in Renal Angioplasty for Severely Calcified Lesions. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:568-572. [PMID: 28533503 PMCID: PMC5447664 DOI: 10.12659/ajcr.903876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The GuideLiner catheter extension device is a monorail-type "Child" support catheter that facilitates coaxial alignment with the guide catheter and provides an appropriate back-up force. This device has been developed in the field of coronary intervention, and now is becoming widely applied in the field of endovascular treatment. However, there has been no report on the effectiveness of the guide catheter extension device in percutaneous transluminal renal angioplasty (PTRA). CASE REPORT We encountered a case of atherosclerotic subtotal occlusion at the ostium of the left renal artery. Due to the severely calcified orifice and weaker back-up force provided by a JR4 guide catheter, we could not pass any guidewires through the target lesion. Therefore, we introduced a guide catheter extension device, the GuideLiner catheter, through the guide catheter and achieved good guidewire maneuverability. We finally deployed 2 balloon-expandable stents and successfully performed all PTRA procedures. CONCLUSIONS The guide catheter extension device can be effective in PTRA for severely calcified subtotal occlusion.
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Affiliation(s)
- Takeshi Sugimoto
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Tetsuya Nomura
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Yusuke Hori
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Kenichi Yoshioka
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Hiroshi Kubota
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Daisuke Miyawaki
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Ryota Urata
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Masakazu Kikai
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Natsuya Keira
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
| | - Tetsuya Tatsumi
- Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan
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Seesaw double GuideLiner® catheter technique for a successful bail-out procedure from blow-out type coronary perforation. Cardiovasc Interv Ther 2016; 32:396-400. [DOI: 10.1007/s12928-016-0436-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
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