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Guide-Extension Facilitated Antegrade Dissection Re-entry: A Case Series
Thomas E Kaier, Andreas Kalogeropoulos, Antonis N Pavlidis1
1Department of Cardiology, St. Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, United Kingdom. antonis.pavlidis@gstt.nhs.uk.
Insights
Treating chronic total occlusions (CTO) with antegrade dissection and re-entry (ADR) is effective. Combining guide extension and trapping balloons, like the TrapLiner, offers technical advantages for complex CTO PCI.
Area of Science:
- Cardiovascular Interventions
- Interventional Cardiology
- Medical Device Technology
Background:
- Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) presents unique challenges.
- Antegrade dissection and re-entry (ADR) is a recognized technique for CTO with high success rates in expert hands.
- Standard CTO interventions often necessitate enhanced guide-catheter support and rapid-exchange systems.
Purpose of the Study:
- To evaluate the technical advantages of using combined guide-extension and trapping devices in ADR procedures.
- To highlight the utility of the TrapLiner guide-extension catheter in facilitating ADR for complex CTOs.
Main Methods:
- A case series approach was employed.
- Focus on ADR techniques facilitated by guide-extension devices.
- Utilized the TrapLiner guide-extension catheter (Teleflex) as a combined device.
Main Results:
- Guide-extension facilitated ADR demonstrated technical advantages.
- The TrapLiner catheter provided effective guide-catheter support and facilitated CTO re-entry.
- Successful application of the technique in complex CTO cases.
Conclusions:
- Combined guide-extension and trapping devices simplify complex CTO interventions.
- The TrapLiner catheter offers a valuable solution for enhanced support in ADR.
- This approach can improve the technical success of CTO PCI.
Abstract:
Treatment of chronic total occlusions poses a specific set of challenges above and beyond those encountered in conventional percutaneous coronary intervention. Antegrade dissection and re-entry (ADR) is an established and safe technique with high success rates in experienced centers. CTO techniques frequently require greater-than-usual guide-catheter support and rapid-exchange technologies. Either can be achieved with separate guide extension and a trapping balloon; in this case series of guide-extension facilitated ADR, we highlight the technical advantages gleaned from the use of combined devices such as the TrapLiner guide-extension catheter (Teleflex).
