title: Successful percutaneous coronary intervention with GuideLiner® catheter for subtotal occlusive lesion in the right coronary artery with anomalous origin from the left sinus of Valsalva: a case report.
abstract: BACKGROUND
  Because of the unusual anatomy of an anomalous origin of the right coronary artery from the left sinus of Valsalva, selective cannulation of the guiding catheter in percutaneous coronary intervention for these cases is always challenging.
  
  
  METHODS
  A 58-year-old Japanese man was admitted to our hospital complaining of worsening exertional chest pain. He was suspected of having unstable angina pectoris and underwent cardiac catheterization. We found a subtotal occlusive lesion in the mid-portion of his right coronary artery that originated from the left sinus of Valsalva. On the previous percutaneous coronary intervention, we failed to cannulate the guiding catheter to the anomalous orifice of the right coronary artery. Therefore, we decided to use the GuideLiner catheter for stable back-up support from the beginning. A 6Fr GuideLiner catheter was introduced into the right coronary artery by anchoring it coaxially with a semi-compliant balloon catheter. And we successfully deployed two drug-eluting stents by crossing over the posterior-descending artery. Final angiography demonstrated favorable dilatation of the target lesion, and native blood flow in the right coronary artery was completely recovered.
  
  
  CONCLUSIONS
  GuideLiner is a monorail-type "child" support catheter that facilitates coaxial guiding catheter engagement and an appropriate back-up force, achieving successful device delivery to target lesions in this kind of complex percutaneous coronary intervention.
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. army0608@hotmail.com.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shirota
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. t2-ya@nike.eonet.ne.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. sbu1626.nagaokakyo-eslups@docomo.ne.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kubota
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. s.taminishi.1223@gmail.com.
authors.forename: Shunta
authors.initials: S
authors.lastname: Taminishi
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. urta.69@gmail.com.
authors.forename: Ryota
authors.initials: R
authors.lastname: Urata
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. takeshi.sugimoto15@gmail.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. yuu.hi0522@gmail.com.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. takukato@koto.kpu-m.ac.jp.
authors.forename: Taku
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. nkeira@yahoo.co.jp.
authors.forename: Natsuya
authors.initials: N
authors.lastname: Keira
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. ttatsumi0221@yahoo.co.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tatsumi
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000628:therapy*; D000787:Angina Pectoris / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging; D015607:Stents