Efficacy and safety of guide extension catheter in balloon pulmonary angioplasty for treatment of complex lesions in chronic thromboembolic pulmonary hypertension
Fig 2
Representative figures of guide extension catheter.
(A) A 6Fr Profit JR4 type guiding catheter was engaged to the left lower lobe branch (A8). 2 mm balloon catheter (IKAZUCHI PAD, KANEKA, Osaka, Japan) could not pass the web lesion and guide extension catheter was used for strengthening backup force. (B) Target vessel in back branch of left lower lobe (A8) had too large a branch angle to obtain coaxiality from the 6Fr Profit JR4 type guiding catheter, so the guide extension catheter was advanced to the target branch through the guidewire and balloon catheter. (C) Pulmonary artery was markedly enlarged and the 6Fr Profit JR4 type guiding catheter did not reach the lingular branch (A5). After a guidewire (B-pahm; Japan Lifeline, Tokyo, Japan) was inserted, we were able to selectively insert the guide extension catheter using the slip-through technique with a 2 mm balloon catheter (IKAZUCHI PAD). The white arrowheads in the left panels of pulmonary angiography show target vessels. The yellow arrowheads show the tip of guiding catheter, and the red arrowheads represent the tip of the guide extension catheter. The black arrowhead is a marker of the balloon catheter.