The transradial approach to coronary angiography, first reported in 1989, offers advantages over the traditional transfemoral approach including decreased incidence of access site complications, earlier ambulation, and improved patient comfort. The use of the Guidezilla guide extension catheter in complex PCI, which in the present single-center, observational study of 188 cases was mainly performed via radial artery access and predominantly for CTO and heavy calcification and in the RCA, appears safe with 1 immediate periprocedural complication, and efficacious with 99% target lesion crossing success and procedural success. The Guidezilla catheter was used mainly when the stent could not cross the lesions even after high pressure balloon predilatation without the need to change the original guiding catheter, and occasionally to pick up the retrograde wire during CTO intervention. If multiple indications were present, the key one leading to Guidezilla catheter use was listed as primary. Patient clinical characteristics, target lesion characteristics, indications for the use of the Guidezilla catheter (namely, coronary artery origin anomalies, heavy tortuosity, heavy calcification, proximal stent, and CTO), and rate of successful target lesion crossing (defined as successful balloon or stent crossing over the target lesion) and of procedural success (defined as successful stents implantation in targeted lesion area) were reviewed and analyzed.

The present real-world study assessed effectiveness of the use of the Guidezilla catheter in PCI of complex lesions performed mainly via radial access.Īfter approval by the Ethics Committee at Zhongshan Hospital, Fudan University, China, the present study retrospectively analyzed data from 188 consecutive PCI cases using the Guidezilla TM guide extension catheter (Boston Scientific, Marlborough, MA) at said hospital from March 2015 to August 2016 by 5 experienced operators each with yearly PCI caseloads of over 500. As a 5F child catheter used with a 6F mother guide catheter, Guidezilla offers support comparable to an 8F ordinary guide catheter thereby allowing to complete most complex cases via radial artery access. The Guidezilla TM guide extension catheter was designed to facilitate complex PCI by efficiently delivering interventional devices, including balloons and stents, when extra backup support is required. In a single center with experienced operators, the use of the Guidezilla guide extension catheter in PCI of complex coronary anatomy performed mostly via radial artery access appeared safe and efficacious, and greatly facilitated device delivery.Ĭomplex coronary anatomy including extreme vessel tortuosity, chronic total occlusions (CTOs), or calcification often renders percutaneous coronary intervention (PCI) challenging and time consuming, with procedural success warranting excellent device support via larger size guiding catheters, buddy wires, strong-support wires, anchoring balloons, and deep insertion of the guiding catheter commonly using a mother-child catheter. Ninety percent of PCI were performed and completed successfully by radial access. Rates of target lesion crossing success and procedural success were both 99%, with one device-related periprocedural complication, namely proximal vessel dissection secondary to deep insertion which was successfully treated with stent implantation. The right coronary artery (48%) was most commonly intervened followed by the left ascending (35%) and left circumflex (17%) arteries. The Guidezilla catheter was used most commonly in PCI of CTOs (45%) and heavy proximal calcification (37%), followed by tortuosity (10%), previously deployed proximal stents (4%), and coronary artery anomaly (4%). Study outcomes were rates of target lesion crossing success, procedural success, and complications. The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. The monorail Guidezilla TM guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.

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