Left main coronary artery bidirectional dissection caused by ejection of guideliner catheter from the guiding catheter

Area of Science:

• Interventional Cardiology
• Medical Device Technology

Background:

• The Guideliner catheter is designed for complex coronary lesions, offering deep engagement and support for stent delivery.
• Percutaneous coronary intervention (PCI) complications include coronary artery dissection, often linked to catheter manipulation.

Observation:

• A case of Guideliner-induced left main dissection is presented following successful revascularization.
• This complication occurred after treating chronic total occlusions in the left anterior descending and left circumflex arteries.

Findings:

• The Guideliner catheter, while effective for complex lesions, was associated with an uncommonly reported left main dissection.
• Deep engagement or noncoaxial alignment of catheters can increase dissection risk.

Implications:

• Awareness of the Guideliner catheter's potential for causing dissection is crucial for interventional cardiologists.
• Careful technique and patient selection are necessary to mitigate risks associated with advanced delivery systems in PCI.