title: The Guideliner™ catheter for stent delivery in difficult cases: tips and tricks.
abstract: BACKGROUND
  Stent delivery in complex coronary anatomy with severe calcification and tortuosity is still a common cause of percutaneous coronary interventions (PCI) failure. Recently, a new support rapid exchange catheter, the Guideliner, has been designed specifically for device delivery.
  
  
  METHODS
  From 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. 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. In 2 cases PTCA with drug-eluting balloon was performed; in the other cases second-generation drug-eluting stent was implanted.
  
  
  RESULTS
  One case, the first one, failed, as stent could not be delivered to the target lesion. The other 9 cases were performed successfully. Three proximal dissections were detected and sealed with stent implantation. In 2 cases, we had stent damage due to the passage of the stent through the Guideliner metal collar. Another stent had to be used.
  
  
  CONCLUSIONS
  In our experience, the Guideliner catheter is safe to use and helps device delivery in difficult settings. 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. Moreover, the aim of this article is to help interventional cardiologists using the device in difficult lesions to avoid potential complications.
authors: Interventional Cardiology Unit, Department of Cardiology, Hospital Del Mar, Paseo Marítimo 25–29, Barcelona, Spain. clarissacola@gmail.com
authors: Clarissa
authors: C
authors: Cola
authors: Faustino
authors: F
authors: Miranda
authors: Beatriz
authors: B
authors: Vaquerizo
authors: Andres
authors: A
authors: Fantuzzi
authors: Jordi
authors: J
authors: Bruguera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D057785:Catheters; D017023:Coronary Angiography / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged