Early clinical experience with Guidezilla for transradial interventions in China

Abstract

Anatomic variations, calcified, tortuous, angulated lesions, and lack of support to increase the complexity of transradial intervention (TRI). Guidezilla is a mother-and-child catheter enabling increased support during complex interventions. As there are few published reports of its use, we describe our experience using this device to assist TRI in Chinese patients. The aim of this study was to investigate the efficacy and safety of the Guidezilla guide extension catheter in complex coronary interventions. Thirty-two patients' clinical characteristics, angiographic details, and in-hospital outcome retrospectively collected between June 2015 and August 2017. Patients were 59.44 ± 10.48 years of age and 26 (81%) were men. The most frequent target vessels were the RCA (34%) and LAD (31%), patients had complex type C (53%) or B (47%) lesions, severely tortuous (41%) and angulated (22%).With the use of Guidezilla, technique success was 100%, and procedural success was 94%. The mean diameter of the deployed stents was 2.97 ± 0.37 mm, and the length was 27.19 ± 8.14 mm. The estimated mean distance of Guidezilla intubation into the target vessel was 7.66 ± 2.29 cm.The Guidezilla catheter extension safely facilitated successful completion of TRI in complex coronary artery lesions. This device can help interventionalists successfully perform difficult procedures.

Figure 1

Characteristics of the Guidezilla and GuideLinerV₂. ID = inner diameter, OD = outer diameter.

Figure 2

Successful treatment of coronary lesions with Guidezilla in elder patient with CKD. (A,B) showing outside medical coronary angiogram results. (C) BMW wire to the distal vessel of RCA. (D) Stenosis of lesions were predilated with 2.75 mm × 20 mm NC balloon. (E) Use the“buddy”wire to improve GC coaxial and support. (F) Guidezilla introduced into the RCA successfully. (G–I) Promus Premier DES were deployed from the distal to the proximal RCA. (J) 2.5 mm anchor balloon technique. 6F Guidezilla was introduced into the distal LCX without difficulty. (K) 2.75 mm × 32 mm Promus Premier DES was delivered and was post-dilated with a 3.0 mm × 12 mm NC balloon. (L) The final coronary angiography shows a good result.