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`GUIDELINER® CATHETER
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`Page 1
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`GuideLiner Catheter is Useful
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`Both for Support and to Minimize
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`Contrast Load by Super-Selective
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`Injections in a High-Risk Chronic
`Renal Failure Patient
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`PHYSICIANS
`Dr. Paolo Danna
`Dr. Alessandra Dozio
`
`Sacco Hospital ofMilan, Italy
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`PRESENTATION
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`Male presents with polycystic kidney disease and stage 4
`chronic renal failure; his cardiovascular history is significant
`for ventricular arrhythmia, syncope, hypertension and
`hyperlipidaemia.
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`He was admitted to the hospital after a syncopal episode with
`post-traumatic renal and retroperitoneal hematoma, which
`was treated with selective embolization ofthe lower branch
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`of left renal artery.
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`Several complications occurred during hospitalization:
`progressive bleeding needing several transfusions, ventricular
`tachycardia (VT), acute pulmonary oedema and non—ST
`elevation myocardial infarction. An echocardiogram showed
`hypokinetic cardiomyopathy with severe reduction of ejection
`fraction (EF) and a mild-to-moderate mitral regurgitation.
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`INITIAL FINDINGS
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`After the stabilization of his hemodynamic state, the patient
`was brought to the cath lab, where coronary angiography
`showed a three-vessel disease.The RCA showed extensive
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`disease and a small calibre, the LCx showed subcritical
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`stenosis of the ostium and mid—segment and a severe lesion
`in its distal part involving the PDA, and the LAD exhibited
`focal proximal disease.
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`TREATMENT
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`The patient was treated via PCI through the right radial
`approach using a 6F guiding catheter. The angioplasty ofthe
`LAD was optimized with a NO-eluting stent.
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`TREATMENT WITH GUIDELINER
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`The PDA was studied with a GuideLiner catheter (Figures 1, 2
`& 3) as the instrument for a selective and minimized injection
`of contrast media. Afterwards, the same system was used to
`support and stabilize the implantation ofan everolimus-eluting
`stent (Figures 4,5 & 6). FFR of LCx was > 0.8, so the vessel was
`not treated.
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`AFTER PCI
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`Renal function was unchanged (serum creatinine, 2.2 mg/100ml)
`during the whole post-procedural stay. ECG monitoring showed
`a reduction in ventricular ectopic activity and subsequent evalu—
`ation showed the absence ofactive kidney bleeding.
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`SUMMARY
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`This case report shows an adjunctive advantage of the GuideLiner:
`minimization of contrast load in by super—selective coronary injec—
`tions, thereby potentially helping in preventing contrast-induced
`nephropathy.
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`In our patient, the use ofthe GuideLiner system allowed the reduc-
`tion of the amount of contrast medium thanks to super—selective
`and optimized injection.This is potentially useful to preserve renal
`function in patients with chronic renal failure or other kidney dis-
`ease undergoing angiographic procedures.
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`It is also important to consider the benefit ofthis system in urgent/
`emergent coronary procedures and in patients without adequate
`preparation against contrast-induced nephropathy.
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`The GuideLiner system improves the selective evaluation of coro—
`nary anatomy, supports the deliverability of stents, and optimizes
`the use of contrast medium by minimizing its total volume with a
`possible consequent reduction in adverse renal events.
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`Dr. Paolo Danna
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`Director, Cardiac Catheterization Laboratory, Ospedale
`Luigi Sacco, Milano, Italy.
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`Dr. Alessandra Dozio
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`Fellow in Cardiology, Ospedale Luigi Sacco,
`Milano, Italy.
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`GuldeLinerCatheters 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 lnstructlonsfor Use fora complete listing ofthe 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 othertradernarks and registered trademarks are property oftheir respective owners.
`©2016VascularSolutions, Inc. All rights reserved. ML2682 Rev. B 10/16
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`Vasemar
`SOLUTIONS
`
`VascularSqutions,|nc.
`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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