4 Fr. Guiding Catheter

Abstract Objective There is limited literature on procedure of primary PCI in catheterization laboratory. This study was designed to assess the impact of electrocardiogram-guided immediate intervention on culprit lesion with a single guiding catheter in ST-elevation myocardial infarction (STEMI) patients on door-to-balloon (D2B) time and clinical outcomes. Methods In this prospective, randomized single center study, 560 patients with STEMI who underwent primary PCI from February 2017 to July 2019 were randomized into two groups. In single catheter group, a single guiding catheter (MAC3.5 or JL 3.5 guiding catheter) was used to perform angiogram and PCI of culprit vessel, followed by contralateral angiography (n=280). In contral group, 280 patients underwent primary PCI after complete diagnostic angiography. The primary evaluation was D2B time and second endpoint include catheterization laboratory-to-balloon (C2B) time, major adverse cardiac events (MACE) at 30 days. This trial was registered with ClinicalTrials.gov, NCT03272451. Results Baseline characteristics were not different between the two groups. The median D2B time (54.83 [IQR 40.00–68.0] min versus 58.32 [IQR 44.12–78.40] min, P=0.007), C2B time (16.91 [IQR 13.88–21.42] min versus 23.80 [IQR 18.92–28.52] min, P<0.001), total procedural time (45.17 [34.06–59.48] min versus 48.51 [37.04–64.60] min, P=0.012) and fluoroscopy time (9.70 [6.50–14.15] min versus 11.26 [8.01–14.27] min, P=0.025)were significantly shorter in single catheter group Compared with control group. The proportion of patients achieving D2B time within 60 minutes increased significantly in the single catheter group (61.79% vs. 52.14%, P=0.021). The rate of radial perforation was significantly reduced in single catheter group (0.71% vs. 3.21%, P=0.033). The total number of catheters was significantly less in single catheter group (1.18±0.54 vs. 2.23±0.60, p<0.001). There was no significant difference in the MACE at 30 days (2.5% vs. 4.64%, P=0.172) between the 2 groups. Conclusion ECG-guided immediate intervention on culprit lesion with a single guiding catheter in STEMI patients can reduce D2B time, C2B time, procedural time and fluoroscopy time. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Capital's Funds for Health Improvement and Research

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Usefulness of lead delivery catheter system for true right ventricular septal pacing

European Heart Journal ◽

10.1093/ehjci/ehaa946.0770 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Miyajima ◽

T Urushida ◽

K Ito ◽

F Kin ◽

A Okazaki ◽

...

Keyword(s):

Right Ventricular ◽

Pacemaker Implantation ◽

Septal Wall ◽

Catheter Group ◽

Catheter System ◽

Septal Pacing ◽

Ventricular Activation ◽

Pacing Lead ◽

Guiding Catheter ◽

Delivery Catheter

Abstract Background Right ventricular (RV) septal pacing is often selected to preserve a more physiologic ventricular activation. But the pacing leads are not always located in true septal wall, rather in hinge or free wall in some cases with the conventional stylet-guided lead implantation. In recent years, new guiding catheter systems has attracted attention as a solution to that problem. Objective The aim of this study is to investigate that true ventricular sepal pacing can be achieved by use of the new guiding catheter system for pacing lead. Methods We enrolled 198 patients who underwent RV septal lead implantation and computed tomography (CT) after pacemaker implantation. 16 cases were used delivery catheter (Delivery), and 182 cases were used stylet for targeting ventricular septum (Conventional). We analyzed the lead locations with CT, and evaluated capture thresholds, R-wave amplitudes, lead impedances and 12-lead electrocardiogram findings one month after implantation. Results All cases of delivery catheter group had true septal lead positions (Delivery; 100% vs Conventional; 44%, p<0.01). Capture thresholds and lead impedances had not significant differences between between two groups (0.65±0.15V vs 0.60±0.15V, p=0.21, 570±95Ω vs 595±107Ω, p=0.39, respectively). R-wave amplitudes were significantly higher in delivery catheter group (13.0±4.8mV vs 10±4.6mV, p<0.01). Paced QRS durations were shorter in delivery catheter group (128±16ms vs 150±21ms, p<0.01). Conclusions The delivery catheter system designated for pacing lead can contribute to select the true ventricular septal sites and to attain the more physiologic ventricular activation. Funding Acknowledgement Type of funding source: None

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Amplatzing a 6 Fr right guiding catheter for increased success in complex right coronary artery anatomy

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.10138 ◽

2002 ◽

Vol 55 (4) ◽

pp. 529-529

Author(s):

Rajpal K. Abhaichand

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Coronary Artery Anatomy ◽

Guiding Catheter

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Efficacy of a direct puncture approach for anterior circulation aneurysms using a newly developed guiding catheter—especially for geriatric patients

Surgical Neurology ◽

10.1016/j.surneu.2006.03.044 ◽

2007 ◽

Vol 67 (1) ◽

pp. 30-34 ◽

Cited By ~ 11

Author(s):

Izumi Yuzawa ◽

Akira Kurata ◽

Sachio Suzuki ◽

Hitoshi Ozawa ◽

Hiroyuki Hagiwara ◽

...

Keyword(s):

Geriatric Patients ◽

Anterior Circulation ◽

Direct Puncture ◽

Anterior Circulation Aneurysms ◽

Guiding Catheter

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Steam-deformed Judkins-left guiding catheter with use of the GuideLiner® catheter to deliver stents for anomalous right coronary artery

SAGE Open Medical Case Reports ◽

10.1177/2050313x15608339 ◽

2015 ◽

Vol 3 ◽

pp. 2050313X1560833

Author(s):

Toshiki Kuno ◽

Taishi Fujisawa ◽

Hiroyuki Yamazaki ◽

Hiroyuki Motoda ◽

Masaki Kodaira ◽

...

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Guiding Catheter

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Effect of aortic arch type on technical indicators in patients undergoing carotid artery stenting

Journal of International Medical Research ◽

10.1177/0300060518807604 ◽

2018 ◽

Vol 47 (2) ◽

pp. 682-688 ◽

Cited By ~ 5

Author(s):

Songhe Shen ◽

Xiongjing Jiang ◽

Hui Dong ◽

Meng Peng ◽

Zhixue Wang ◽

...

Keyword(s):

Carotid Artery ◽

Contrast Agent ◽

Aortic Arch ◽

Carotid Artery Stenting ◽

Influential Factor ◽

Fluoroscopy Time ◽

Type I ◽

Technical Indicators ◽

Type Iii ◽

Guiding Catheter

Objective This study was performed to explore the effect of the aortic arch type on technical indicators in patients undergoing carotid artery stenting (CAS). Methods The data of 224 consecutive patients who underwent unilateral CAS from January 2011 to December 2012 were retrospectively analyzed. The requirement for placement of the guiding catheter into the common carotid artery with assistance of an angiographic catheter, fluoroscopy time, contrast agent dose, and adverse events were recorded. Results The fluoroscopy time was significantly longer and the contrast agent dose was significantly higher in patients with Type III than Type I and II arches. Significantly more patients with Type III than Type I and II arches required placement of the guiding catheter with assistance of an angiographic catheter (46.2% vs. 15.0%, respectively). The procedural success rate was significantly lower in patients with Type III than Type I and II arches (96.2% vs. 100.0%, respectively). The incidence of death, myocardial infarction, and all types of stroke was significantly higher in patients with Type III than Type I and II arches (7.7% vs. 1.7%, respectively). Conclusions The aortic arch type is an important influential factor in CAS. Type III arches are associated with more difficulties and complications.

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Case Report: STENT DISLODGEDMENT

Folia Medica Indonesiana ◽

10.20473/fmi.v52i3.5455 ◽

2017 ◽

Vol 52 (3) ◽

pp. 219

Author(s):

Yudi Her Oktaviono

Keyword(s):

Myocardial Infarction ◽

Ascending Aorta ◽

Heavy Smoker ◽

Significant Stenosis ◽

Diffuse Disease ◽

Pull Out ◽

Old Myocardial Infarction ◽

The Right ◽

Diagnostic Coronary Angiography ◽

Guiding Catheter

Male 61 years old who presented with stable angina since 1 month ago, with Risk factor of CAD: hypertension, Dyslipidemia and heavy smoker. The ECG showed inferior old myocardial infarction. Diagnostic coronary angiography found: bifurcatio lesion at distal LMCA with significant stenosis 60% at the distal LM and 85% at the osteal LCx (Medina score 1-1-0), high D1 and diffuse disease with maximal stenosis 85% at the distal LAD after D2, Significant stenosis 85% at the osteal LCx and CTO at the distal after OM1, diffuse disease with maximal stenosis 85% at the mid RCA. A 6-Fr JR 4.0 guiding catheter (Launcher, Medtronic) was engaged into the right coronary artery ostium via the femoral artery. GW pilot 50 (Hi-Torque Pilot 50) inserted to distal RCA. Perform Balloon support by Saphire II inserted to mid RCA and dilated, after that perform balloon to proximal RCA and dilated. Stent DES Firebird II (Rapamycin) to mid RCA and dilated. Stent BMS Apollo 3.0x36 mm inserted to proximal-mid RCA, overlapping with previous stent, but was loss or dislodged and insert to the guiding catheter. BMS stent was pulled out with small balloon ex stent. GC 6F 4.0 inserted to ascending Aorta and engaged at ostium RCA. BMS stent Arthos PICO 3.0x 34 mm inserted to proximal-mid RCA, overlapping with previous stent and dilated. Final angiography confirmed successful pull out of loss stent and dilation of the RCA.

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Performance Analysis of a Novel Hydrophilic-Coated Transradial Guiding Catheter

Clinical Cardiology and Cardiovascular Interventions ◽

10.31579/2641-0419/128 ◽

2021 ◽

Vol 4 (4) ◽

pp. 01-06

Author(s):

A.J.J. IJsselmuiden

Keyword(s):

Coronary Intervention ◽

Complication Rates ◽

Stent Deployment ◽

Coronary Syndrome ◽

Timi Grade ◽

Cerebrovascular Events ◽

Percutaneous Coronary ◽

Procedural Success ◽

Grade 3 ◽

Guiding Catheter

Aim: The transradial approach (TRA) has taken an upswing, however access-site complications still exist. The choice of potentially less traumatic materials may minimize these complications. This article describes the use of a hydrophilic-coated 6F guiding catheter for diagnostic and interventional procedures and upper extremity dysfunction following these procedures. Materials and Methods: This prospective observational study enrolled 217 patients who underwent elective transradial percutaneous coronary intervention (TR-PCI) for stable and unstable angina, or acute coronary syndrome between May 2014 and November 2016. All patients were treated using a 6F hydrophilic-coated guiding catheter (PRIMUM, PendraCare, Wellinq, the Netherlands). Catheter performance was assessed on a five-point scale ranging from very bad to very good. Procedure safety was assessed using the Major cardiac and cerebrovascular events (MACCE) criteria. Results: The average number of guiding catheters used was 1.2 per patient. Overall performance of the catheters was rated Average/Good. Procedural success, defined as TIMI grade 3 flow and successful stent deployment, with a residual diameter stenosis of <25%, was 97.7%. MACCE occurred in 1.5% during the 6-months of follow-up. Conclusion: These data indicate that the use of a hydrophilic-coated guiding catheter to perform percutaneous coronary interventions is safe and effective, with high procedural success and low complication rates. In addition, the short and long-term MACCE outcomes of the PCI were favorable.

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