Successful Distal Stent Delivery
Past Multiple Previous Stents Made
Possible by the GuideLiner® catheter
Presentation
The patient is a 62 year old male with a history of:
- diabetes mellitus
- hyperlipidemia
- hypertension
- coronary artery disease
He has undergone a 4 vessel coronary artery bypass grafting and has had multiple interventions on a saphenous vein graft to the Ramus, with implantation of bare metal and drug-eluting stents (figure 1). He returned for treatment after developing disabling angina.
Initial Findings
Coronary angiography confirmed a lesion at the distal stent edge, beyond multiple previously placed stents, within the vein graft, extending into the native vessel (figure 2).
Subsequent Treatment
Two months after the balloon angioplasty was performed, the patient returned with recurrent angina. The SVG to the Ramus was cannulated with an AL1 guide catheter. The GuideLiner was advanced through the guide catheter and a Prowater™ wire was advance to the lesion through the GuideLiner. A 2.5mm x 12mm Sprinter® balloon was placed at the distal lesion and inflated. With the distal anchor balloon inflated, the GuideLiner was advanced into the vein graft through the prior areas of stented graft that had given so much difficulty passing on the previous procedures (figure 3). With the GuideLiner in place, a Promus® stent passed easily to the distal lesion and was successfully deployed at 18 atms. A good angiographic result and positive patient outcome was achieved. (figure 4)
Summary
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By allowing the delivery of a stent through a saphenous vein graft with multiple previous stent implantations, the GuideLiner made possible the treatment of this difficult and persistent distal lesion.
Lorem Ipsum Header
By allowing the delivery of a stent through a saphenous vein graft with multiple previous stent implantations, the GuideLiner made possible the treatment of this difficult and persistent distal lesion.
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