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`GUIDELINER® CATHETER
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`Use of the GuideLiner Catheter
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`to Reduce Contrast in Patients
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`wi..h
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`nall su we .cy
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`PHYSICIAN
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`Kishor Vora, MD, FSCAI, FACC
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`Owensboro Medical Health System, Owensboro, Kentucky, USA
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`PRESENTATION
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`Male patient with a history of hypertension presented
`with recent acute pulmonary edema, angina, ischemic
`cardiomyopathy (ICM), chronic kidney disease (CKD stage III)
`and a glomerular filtration rate (GFR) of45.1.
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`INITIAL FINDINGS
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`SPECT assessment was abnormal, revealing inferior wall
`ischemia and an ejection fraction (EF) of 25%. Angiographic
`findings revealed a 90% lesion mid-PDA (Figure 1).
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`TREATMENT
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`A 6F lkari Left 3.5 guide catheter was inserted via right radial
`access. Because the patient had Stage III CKD, a 6F GuideLiner
`was then inserted for super-selective injections to reduce
`contrast (Figure 2). Direct stenting ofthe PDA lesion was
`performed with a 2.5 X 15mm XIENCE Xpedition® everolimus
`eluting coronary stent over a 190cm Hi-Torque Balance
`Middleweight® guidewire (Figures 3 and 4) and the stent
`was post dilated with a 2.5 X 8mm NC Quantum ApexTM PTCA
`dilation balloon (Figure 5).
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`(continued on back)
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`CONCLUSION AND POST PROCEDURE
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`The mid—PDA stenosis was reduced from 90% to 0% post—stent
`deployment (Figure 6). Contrast usage was limited to 60cc for
`the entire procedure, including coronary angiography and stent
`placement, by using super-selective injections to the target
`location and minimizing contrast runoff into ipsilateral coronary
`vessels.
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`SUMMARY
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`PCI ofthe PDA was successfully performed in a patient with
`CKD Stage “I using the GuideLiner for super-selective injections
`to minimize contrast use. Both diagnostic and interventional
`portions of this procedure were completed using a total contrast
`amount of 60cc.
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`Kishor Vora, MD, FSCAI, FACC
`As Medical Director, President and Founder of
`Owensboro Heart and Vascular, KishorVora,
`MD, FSCAI, FACC is board certified in Internal
`Medicine and Cardiovascular Disease. Having
`received his MD from Grant Medical College
`at the University of Born bay (Bombay, India),
`he specializes in cardiology, cardiovascular
`disease, internal medicine, and interventional
`cardiology. Dr. Vora is a fellow ofthe Society
`for Cardiac Angiography and Interventions as
`well as the American College of Cardiology.
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`GuideLinerCatheters areintended to be used in Conjunction with guide Catheters to aCCess discrete regions ofthe Coronary
`and/or peripheral vasculature, and to facilitate placementand exchange ofguideWIres and other interventional devices.
`Pleasesee the lnstructionsfor Use fora complete listing nfthe indications, contraindications, warnings and precautions.
`CAUTION: Federal law (U.S.A.) restricts this deviceto sale by or on theorder of a physician.
`GuideLiner is a registered trademarkofVascularSolutions, Inc.
`All other tradema rks and registered trademarks are property oftheir respective owners.
`©2016VascularSolutions, Inc. All rights reserved. ML1758 Rev. C 10/16
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`'SOLU'I‘IUNS
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`Vascular Solutions, Inc.
`6464 Sycamore Court North
`Minneapolis, Minnesota 55369 USA
`Customer Service:
`United States: 888.240.6001
`International: (001) 763.656.4298
`customerservice@vasc.com
`www.vasc.com
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`VSIQXM_EOOO44790
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`Teleflex Ex. 2182
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`Medtronic v. Teleflex
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`Page 2
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`Teleflex Ex. 2182
`Medtronic v. Teleflex
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