Fig 1.
The guide extension catheter is a rapid-exchange type catheter that provides backup support to deliver intervention devices such as balloons in difficult cases.
Table 1.
Baseline population characteristics.
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.
Table 2.
Procedure characteristics.
Table 3.
Procedural results.
Table 4.
Procedural results by lesion types.
Table 5.
Failed cases.
Fig 3.
Case of complication with vascular dissection by guide extension catheter.
(A) Pulmonary angiography at right middle lobe (A5) with a 6Fr Profit JR4 guiding catheter before BPA. (B) 1 mm Balloon catheter (IKAZUCHI Zero, KANEKA, Osaka, Japan) could not pass the web lesion (Black arrowhead indicates the tip of the balloon catheter). (C) After the guide extension catheter was advanced to strengthen backup force, the balloon catheter was able to cross the lesion (Red arrowhead represents the tip of the guide extension catheter). (D) Angiography after balloon dilatation revealed severe vascular dissection due to guide extension catheter. (E) After the guidewire (B-pahm 0.6 g) had passed through the true lumen confirmed with intravascular ultrasound (IVUS, Eagle Eye Platinum; Volcano, San Diego, CA), balloon dilation with large diameter balloon (4.0 mm IKAZUCHI PAD) was performed. (F) Final angiography demonstrated successful bailout with anterograde flow to the distal branches.
Table 6.
Complications.