C l i n i C a l C a s e
`
`c omplex p rimary pci For st e levation
`myocardial i nfarction Facilitated By
`t he GuideLiner ® c atheter
`
`physician
`Islam A. Bolad, MD
`Location
`Roudebush VA Medical Center, Indianapolis, Indiana, USA
`presentation
`A 58 year old gentleman with hypertension presented to our
`emergency room with inferior STEMI. He was taken emergently
`to the cardiac catheterization laboratory for coronary
`angiography and primary PCI.
`initiaL FinDinGs
`Coronary angiography showed a tortuous right coronary artery
`(RCA) with an occlusive thrombus in the mid to distal coronary
`segment (Figure 1). The left coronary system was unremarkable.
`treatment
`The ostium of the RCA was engaged using a 6F ART 3.5 guide
`catheter. A BMW guidewire would not advance past the
`proximal RCA segment. A polymer covered ChoICE® PT floppy
`guidewire with balloon support crossed the thrombotic
`lesion into the distal RCA (Figure 2). A 3 x 15mm Trek balloon
`was passed with difficulty into the lesion and angioplasty
`performed. Attempts to pass a 4 x 23mm Xience V® drug eluting
`stent were unsuccessful and the stent would not pass through
`the proximal RCA.
`A 6F GuideLiner was then used, the tip of which was positioned
`in the distal RCA using the 3mm Trek as an anchoring balloon
`(Figures 3 & 4). The 4 x 23mm Xience V stent was then delivered
`to the lesion site, the GuideLiner catheter withdrawn, and the
`stent deployed (Figure 5). An excellent angiographic result was
`obtained (Figure 6).
`
`(continued on back)
`
`150cm
`
`1cm
`
`25cm rapid exchange section
`
`Figure 1
`
`Figure 2
`
`Figure 3
`
`.062
`
`7F
`
`
`Page 1
`
`Teleflex Ex. 2185
`Medtronic v. Teleflex
`IPR2020-00135
`
`

`

`c omplex p rimary pci For st e levation
`myocardial i nfarction Facilitated By
`t he GuideLiner c atheter
`
` & post proceDUre
`concLUsion
`The GuideLiner catheter is a new tool which facilitates complex
`primary PCI in STEMI patients. It saves critical time in this patient
`subset. It makes the difference between success and failure and
`converts an impossible case to a possible one.
`sUmmary
`The GuideLiner catheter allowed the delivery of a large drug
`eluting stent through a very tortuous artery to the lesion
`site. Importantly, the pressure from the tip of the GuideLiner
`catheter showed that flow was maintained normally with no
`ventriculization or damping, and angiographically it was noted
`that the GuideLiner conformed to the vessel tortuosity and did
`not kink the vessel, which would have occurred if stiff wires were
`used to facilitate delivery of the stent.
`
`Islam A. Bolad, MD
`Interventional Cardiologist, Krannert Institute of Cardiology
`Indiana University School of Medicine
`Fellow of the American College of Cardiology
`Fellow of the European Society of Cardiology
`
`Figure 4
`
`Figure 5
`
`Figure 6
`
`GuideLiner catheters are intended to be used in conjunction with guide catheters to access discrete regions of the coronary and/or peripheral
`vasculature, and to facilitate placement and exchange of guidewires and other interventional devices.
`Please see the Instructions for Use for a complete listing of the indications, contraindications, warnings and precautions.
`
`CAUTION: Federal law (U.S.A.) restricts this device to sale by or on the order of a physician.
`
`GuideLiner is a registered trademark of Vascular Solutions, Inc. All other trademarks and registered trademarks are property of their respective owners.
`
`©2012 Vascular Solutions, Inc. All rights reserved. ML2642 Rev. A 08/12
`
`Vascular Solutions, Inc.
`6464 Sycamore Court
`Minneapolis, Minnesota 55369 USA
`Customer Service:
`United States: 888.240.6001
`International: (001) 763.656.4298
`customerservice@vasc.com
`
`www.vasc.com
`
`
`Page 2
`
`Teleflex Ex. 2185
`Medtronic v. Teleflex
`IPR2020-00135
`
`