![]() The distal anchoring technique with a 2.5 NC balloon was also attempted but was unsuccessful. A 6 French GuideLiner was used but would not advance beyond the ostium of the RCA. Despite predilatation with a 2.0 and a 2.5 noncompliant balloon at high pressure, stent delivery proved quite difficult. The RCA was diffusely diseased with stenosis extending from the distal RCA to the ostium (Figure 2(a)). The lesion was crossed easily with a Pilot 50 wire restoring distal flow. ![]() Coronary angiography showed an occluded mid right coronary artery (RCA) with brisk collaterals from the left anterior descending artery (LAD). Case 1 A 72-year-old male presented with a non-ST elevation myocardial infarction (NSTEMI). The same steps are followed for previously stented segments as shown in Figure 1(c).Ģ. Once the GuideLiner is advanced to the target segment the balloon is deflated. The balloon is then inflated to nominal pressure and then both the balloon and the GuideLiner are advanced into the vessel while anchoring the guidewire (Figure 1(b)). Is advanced until protruding halfway beyond the tip of the GuideLiner (Figure 1(a)). ![]() GuideLiner or 2.0 × 15 mm balloon for a 6 Fr. After successful crossing of the lesion with a guidewire and adequate predilatation, a compliant 1.5 × 15 for a 5.5 Fr. The main process of GBAT technique involves the following. The “GuideLiner Balloon Assisted Tracking” (GBAT) is relatively easy to perform and has a low risk of complications. We describe a novel technique that would facilitate delivery of the GuideLiner catheter across difficult segments and increase procedural success rates. This sometimes can be difficult through tortuous and calcified vessels or through previously stented segments. To increase success rates, the GuideLiner should be delivered as close as possible to, and sometimes across, the target coronary lesion. Stent delivery failure occurs in up to 5% of all PCI cases, which can result in suboptimal revascularization and has been associated with increased complication rates The GuideLiner catheter, a mother-and-child catheter that can be delivered deep into the coronary artery, provides excellent support and facilitates stent delivery. Despite improvements in-stent profile, stent delivery can still be problematic in complex coronary anatomy. Introduction With the advent of drug-eluting stents, an increasing number of difficult lesions are treated by percutaneous intervention (PCI). This technique is termed GuideLiner Balloon Assisted Tracking (GBAT).ġ. This technique can be applied to 5.5 Fr., 6 Fr., and 7 Fr. In cases which the GuideLiner catheter cannot be advanced even with balloon anchoring technique, we inflate a noncompliant balloon protruding from the GuideLiner catheter at nominal pressure and both the GuideLiner and the balloon are advanced over the coronary guidewire through the tortuous segments. The use of guide extension catheters, such as GuideLiner, allows for increased guide support and facilitates device delivery in tortuous vessels. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Ribeiro Copyright © 2016 Basem Elbarouni et al. Boniface Hospital, University of Manitoba, Winnipeg, MB, Canada Correspondence should be addressed to Amir Ravandi Received 4 November 2016 Accepted 14 December 2016 Academic Editor: Expedito E. Hindawi Publishing Corporation Case Reports in Cardiology Volume 2016, Article ID 6715630, 4 pages Ĭase Report GuideLiner Balloon Assisted Tracking (GBAT): A New Addition to the Interventional Toolbox Basem Elbarouni, Motaz Moussa, Malek Kass, Olga Toleva, Minh Vo, and Amir Ravandi Section of Cardiology, St.
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