New guiding catheter configuration for aortocoronary vein graft angioplasty

A new family of four guiding catheters (8 French and 9 French) has been developed for angioplasty of aortocoronary vein grafts and native coronary arteries beyond vein graft insertions. In 67 consecutive grafts and native vessels dilated through the grafts in 54 patients, the procedural success rate was 97%. The G-1 standard catheter was employed for the majority of the procedures (66%), but the G-3 catheter was better for high anterior grafts and the G-4 catheter was better for high left grafts. The G-2 catheter was better for lower right grafts, especially in dilated aortas. Balloon angioplasty alone using 8 French catheters was performed in 60 procedures, and excimer laser with adjunctive balloon angioplasty using 9 French catheters was performed in 7 procedures. These unique guiding catheters provide an attractive alternative to existing vein graft guides by their improved seating and backup support. They may be the primary choice for vein graft angioplasty and may have future application in stent deployment and transluminal extraction catheter (TEC) atherectomy.