` GUIDELINER® CATHETER
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`Use of the GuideLiner Catheter
`to Reduce Contrastin Patients
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`Renal Insufficiency
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`PHYSICIAN
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`Kishor Vora, MD, FSCAI, FACC
`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 Ill)
`and a glomerular filtration rate (GFR) of 45.1.
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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 Ikari Left 3.5 guide catheter wasinserted 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 of the 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 Apex™ PTCA
`dilation balloon (Figure 5).
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` (continued on back)
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`The mid-PDA stenosis was reduced from 90% to 0% post-stent
`deployment (Figure 6). Contrast usage waslimited 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 of the PDA wassuccessfully performed in a patient with
`CKDStage Ill 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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` CONCLUSION AND POST PROCEDURE
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`Kishor Vora, MD, FSCAI, FACC
`As Medical Director, President and Founder of
`Owensboro Heart and Vascular, Kishor Vora,
`MD, FSCAI, FACC is board certified in Internal
`Medicine and Cardiovascular Disease. Having
`received his MD from Grant Medical College
`at the University of Bombay (Bombay, India),
`he specializesin cardiology, cardiovascular
`disease, internal medicine, and interventional
`cardiology. Dr. Vora is a fellow of the Society
`for Cardiac Angiography and Interventions as
`well as the American College of Cardiology.
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`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 exchangeof guidewires and other interventional devices.
`Please see theInstructions for Use fora completelisting of the indications, contraindications, warnings and precautions.
`CAUTION:Federal law (U.S.A.) restricts this device to sale by or on the orderof a physician.
`GuideLineris a registered trademark of Vascular Solutions,Inc.
`All other trademarks and registered trademarks are property of their respective owners.
`©2016 Vascular Solutions,Inc.All rights reserved. ML2758 Rev. C 10/16
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`Neue
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`Vv OLUTIONS
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`Vascular Solutions,Inc.
`6464 Sycamore Court North
`Minneapolis, Minnesota 55369 USA
`CustomerService:
`United States: 888.240.6001
`International: (001) 763.656.4298
`customerservice@vasc.com
`www.vasc.com
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`Teleflex Ex. 2182
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