title: Extended use of the GuideLiner in complex coronary interventions.
abstract: OBJECTIVE
  Challenging coronary anatomies including chronic total occlusions (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries pose difficulties in coronary interventions. The GuideLiner is a monorail catheter originally developed to facilitate delivery of stents to target lesions in tortuous vessels. We conducted a study on the feasibility and safety of utilising this catheter in a wider array of complex coronary interventions.
  
  
  RESULTS
  Consecutive patients undergoing coronary or peripheral interventions where a GuideLiner was used were recruited into this study. Patient demographics, lesion and vessel characteristics, procedural details and outcomes were prospectively entered into our database and analysed. From September 2009 to October 2011, 54 consecutive patients underwent coronary intervention in our institution using a GuideLiner; 21 out of 54 coronary applications were motivated by the need to increase support to cross CTOs, predominantly of the RCA. Anomalous or angulated take-off of the treatment vessels (31%), previously deployed proximal stents (15%), heavy proximal calcification (9%) and tortuosity (7%) accounted for the remaining reasons. One patient had successful renal denervation with the aid of a GuideLiner catheter. Procedural success was 98% in our series with no device-related periprocedural complications such as ostial dissection or myocardial necrosis.
  
  
  CONCLUSIONS
  The use of a GuideLiner facilitates the approach to complex coronary interventions including chronic total occlusion and saphenous vein graft intervention by providing greater back-up support and easier engagement of coronary ostia.
authors.affiliation: International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom.
authors.forename: Pak Hei
authors.initials: PH
authors.lastname: Chan
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alegria-Barrero
authors.forename: Nicholas
authors.initials: N
authors.lastname: Foin
authors.forename: Manuel
authors.initials: M
authors.lastname: Paulo
authors.forename: Alistair C
authors.initials: AC
authors.lastname: Lindsay
authors.forename: Nicola
authors.initials: N
authors.lastname: Viceconte
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D006328:Cardiac Catheterization / Q000379:methods; D062906:Cardiac Catheters; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome