title: Experience and complications associated with use of guide extension catheters in percutaneous coronary intervention.
abstract: OBJECTIVE
  To investigate the utility and safety of the GuideLiner "mother-and-child" catheter system during transradial and transfemoral percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  In patients with complex coronary anatomy, stent delivery can be challenging and result in procedural failure and complications. The GuideLiner is a coaxial guide extension system designed to enable deep vessel engagement and facilitate device delivery. The purpose of this study was to evaluate procedural success and safety in a series of GuideLiner-facilitated PCI.
  
  
  METHODS
  Single center retrospective study of PCI utilizing the GuideLiner catheter between February 2010 and October 2014. Patients who underwent PCI without GuideLiner use during the same time period were used as controls for comparison.
  
  
  RESULTS
  A total of 363 cases of GuideLiner-facilitated PCI were identified from 6,088 unique PCI procedures performed during this same time period. Patients in the GuideLiner group were older (mean age 71.5 vs. 67.8, P < 0.001) and had more multivessel disease (72% vs. 63%, P = 0.001) compared with controls. Type C lesions were present in 78% of GuideLiner cases. Procedural success resulting in successful device delivery with the GuideLiner catheter was 80.2%. Stent deformation associated with GuideLiner use occurred in 2.2% (8/363), with the incidence of this complication decreasing over device iterations. Coronary dissection attributed to GuideLiner occurred in 3.3% (12/363) and became less frequent over the study period.
  
  
  CONCLUSIONS
  In this consecutive series of GuideLiner supported PCI, the guide extension system enabled procedural success in the majority. A decline in device-associated complications over time may be attributed to operator learning curve, patient selection, and improvement in catheter design. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Waterbury
authors.affiliation: Minneapolis Heart Institute, Abbott Northwestern, Minneapolis, Minnesota.
authors.forename: Paul
authors.initials: P
authors.lastname: Sorajja
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Bell
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Lennon
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Verghese
authors.initials: V
authors.lastname: Mathew
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Mandeep
authors.initials: M
authors.lastname: Singh
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Gurpreet S
authors.initials: GS
authors.lastname: Sandhu
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gulati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D062906:Cardiac Catheters; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D002983:Clinical Competence; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011677:Punctures; D017534:Radial Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: PCI complications; complex PCI; interventional devices