Guide extension proximal locking method: standardization of maximum backup force in percutaneous coronary...

Area of Science:

• Cardiovascular Interventions
• Medical Device Technology
• Interventional Cardiology

Background:

• Percutaneous coronary intervention (PCI) often requires substantial guide catheter backup.
• Existing methods like KIWAMI-Lock offer strong backup but can be complex.
• A simpler, effective method for enhancing guide catheter support is needed.

Purpose of the Study:

• To develop and evaluate a novel guide-extension proximal locking (GP-Lock) method using the GUIDE PLUS® 5Fr catheter.
• To compare the backup force and procedural efficiency of the GP-Lock method against conventional techniques.
• To assess the clinical utility of GP-Lock in complex PCI.

Main Methods:

• Experimental comparison of backup force for GP-Lock, KIWAMI-Lock, and side branch balloon anchoring.
• Clinical study comparing procedural outcomes of GP-Lock (17 cases) versus KIWAMI-Lock (17 cases).
• Utilized the smallest diameter guide-extension catheter (GUIDE PLUS® 5Fr) for the GP-Lock technique.

Main Results:

• GP-Lock demonstrated significantly higher backup force (293.7 gf) compared to KIWAMI-Lock (270.4 gf) and side branch balloon anchoring (182.7 gf) (P < 0.0001).
• GP-Lock preparation time was substantially shorter (5.0 min) than KIWAMI-Lock (11.0 min) (P < 0.001).
• The GP-Lock method successfully facilitated device passage in complex PCI cases.

Conclusions:

• The GP-Lock method, utilizing the GUIDE PLUS® 5Fr catheter, offers the strongest backup force among tested methods.
• GP-Lock provides a simpler and more efficient alternative to existing techniques like KIWAMI-Lock.
• This technique is highly effective for overcoming device delivery challenges in complex PCI.