Eduardo Silveira ORCID , João Vitor Slaviero ORCID, Alexandre Azmus ORCID, Cláudio Vasques de Moraes ORCID, Julio Vinicius Teixeira ORCID, Rogério Sarmento Leite ORCID, André Manica ORCID, Henrique Gomes ORCID, Claudio Moraes, Eduardo Azevedo ORCID, Julia Kurtz Teixeira ORCID, Felipe Fuchs ORCID, Pedro Piccaro ORCID, Alexandre Schaan de Quadros ORCID

DOI: 10.31160/JOTCI202331A20230009

Abstract

Background

Guide catheter extensions provide increased support in complex percutaneous coronary interventions. The Expressman™ is a novel guide catheter extension and the objective was to assess the impact of its use on procedural success and complications in a high-volume reference center.

Methods

We analyzed data from all consecutive procedures in which the Expressman™ guide catheter extension was used. The decision to use a guide catheter extension was at operator’s discretion. Device success was defined as the successful positioning of the guide catheter extension in the coronary vessel and procedural success was defined as <20% residual stenosis and TIMI 3 flow, with no loss of significant side branches. Major adverse cardiac and cerebrovascular events were defined as the composite of all-cause death, myocardial infarction, target vessel revascularization and stroke.

Results

From April 2022 to January 2023, 34 procedures were included. The majority of the patients were male (59%) and the mean age was 66.5 years. Guide catheter extension use was not planned pre-procedure in 17 procedures (50%). The most common reasons for guide catheter extension use were target vessel angulation or tortuosity and unfavorable coronary ostium position. Device success was obtained in 88% and revascularization success in 91%. There were three side branch occlusions. During in-hospital clinical follow-up, no major adverse cardiac and cerebrovascular events or major bleeding occurred.

Conclusions

The device success and procedural success were high and the rate of complications was low. Guide catheter extension use as bailout technique in complex anatomies allowed procedural success in the vast majority of otherwise untreatable patients.

Keywords

Cardiac catheters; Coronary artery diseases; Equipment design; Percutaneous coronary intervention; Treatment outcome

Read the full paper: https://jotci.org/article/initial-experience-with-the-expressman-guide-catheter-extension-in-a-high-volume-tertiary-cardiology-center/