tortuous guideliner support catheter techniques

We thought that the GuideLiner (Japan Lifeline) would effectively overcome the problem of incorrect guiding a coaxial catheter due to the anomalous origin and inserted the GuideLiner with an anchoring balloon (Online Video 3). Then, we anchored a predilatation 2.0 × 12-mm 2 balloon (Lifespear HP ® (Japan Lifeline, Tokyo, Japan)) to engage coaxially ( Figure 1(d) Online Video 2). We inserted a guidewire (Sionblue ® (Asahi Intecc, Nagoya, Japan)) with a microcatheter (Caravel ® (Asahi Intecc, Nagoya, Japan)) and crossed the lesion. After bending it with hot steam, I put it in normal saline to cool for fixing the shape in the blood with the temperature around 37°. Since we could not engage using either the Amplatz-left or Judkins-left diagnostic catheter, we proceeded to PCI with a 6-F Profit ® Judkins-left guiding catheter (Goodman, Gifu, Japan), deformed by hot steam ( Figure 1(c)). Coronary angiogram with 4Fr diagnostic catheter, Heartcath ® (Terumo, Tokyo, Japan) for both right and left coronary artery revealed an anomalous RCA origin from the left coronary cusp with 99% stenosis in the midportion of the RCA ( Figure 1(a) and (b) Online Video 1). Since neither radial artery’s diameter appeared sufficient for a standard 6-F sheath, we applied a 6-F sheath via a transfemoral approach. After stabilizing heart failure with noninvasive positive pressure ventilation and intravenous nitrate and furosemide, we performed coronary angiography. Echocardiography revealed diffuse hypokinesia and a 40% ejection fraction. Her creatine kinase level was 960 IU/L, and the MB isozyme level was 120 IU/L. The electrocardiogram showed ST depression in V4-6 leads. She had a history of hypertension and type 2 diabetes mellitus. All subjects Allied Health Cardiology & Cardiovascular Medicine Dentistry Emergency Medicine & Critical Care Endocrinology & Metabolism Environmental Science General Medicine Geriatrics Infectious Diseases Medico-legal Neurology Nursing Nutrition Obstetrics & Gynecology Oncology Orthopaedics & Sports Medicine Otolaryngology Palliative Medicine & Chronic Care Pediatrics Pharmacology & Toxicology Psychiatry & Psychology Public Health Pulmonary & Respiratory Medicine Radiology Research Methods & Evaluation Rheumatology Surgery Tropical Medicine Veterinary Medicine Cell Biology Clinical Biochemistry Environmental Science Life Sciences Neuroscience Pharmacology & Toxicology Biomedical Engineering Engineering & Computing Environmental Engineering Materials Science Anthropology & Archaeology Communication & Media Studies Criminology & Criminal Justice Cultural Studies Economics & Development Education Environmental Studies Ethnic Studies Family Studies Gender Studies Geography Gerontology & Aging Group Studies History Information Science Interpersonal Violence Language & Linguistics Law Management & Organization Studies Marketing & Hospitality Music Peace Studies & Conflict Resolution Philosophy Politics & International Relations Psychoanalysis Psychology & Counseling Public Administration Regional Studies Religion Research Methods & Evaluation Science & Society Studies Social Work & Social Policy Sociology Special Education Urban Studies & Planning BROWSE JOURNALSĪn 88-year-old woman was admitted because of non ST-elevation myocardial infarction and pulmonary edema.

Tortuous guideliner support catheter techniques