PMC5225327_01
Successful PCI of the RCA using the GBAT technique. (a) Diffusely diseased RCA after predilatation. (b) Advancement of the GuideLiner using GBAT; black arrow indicated the tip of the GuideLiner. (c) Successful PCI of the RCA.
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fig2
The RCA was diffusely diseased with stenosis extending from the distal RCA to the ostium (Figure 2(a)). The GuideLiner was easily advanced to the distal RCA (Figure 2(b)) facilitating stent delivery and procedural success (Figure 2(c)).
PMC5225327_02
Successful PCI of LAD after using GBAT technique. (a) Predilation of the lesion with a 2.0 x 15 mm noncompliant balloon. (b) Successful advancement of the GuideLiner across the lesion with an inflated balloon at the tip; the black arrow refers to the GuideLiner with the protruding compliant balloon. (c) Successful stent delivery and PCI of the proximal LAD.
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fig3
PCI was performed on a 90% mid LAD lesion in a tortuous segment (Figure 3(a)). GuideLiner a stent would not cross the lesion. GBAT technique was used to successfully cross the lesion with the GuideLiner (Figure 3(b)). This facilitated stent delivery and procedure completion (Figure 3(c)).
PMC5225327_03
Successful PCI of the LAD using GBAT. (a) Diffusely diseased proximal LAD. (b) GBAT assisted advancement of the GuideLiner passes the proximal stenosis; black arrow indicated the GuideLiner as it passes the lesion with an inflated balloon. (c) Successful PCI to the LAD.
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fig4
Coronary angiography through the femoral approach showed a diffusely diseased proximal LAD with TIMI 2 flow (Figure 4(a)). We next inflated a 1.5 x 15 mm balloon that was protruding from the GuideLiner to 8 atm and managed to push the GuideLiner and the inflated balloon past the proximal LAD lesion (Figure 4(b)). Next the mid to proximal LAD was stented with DES with great angiographic result (Figure 4(c)).
PMC5225327_04
(a) Mid RCA severe lesion with moderate ISR of the proximal vessel. (b) Advancement of the GuideLiner through previously stented segment using GBAT; black arrow indicated the GuideLiner as it passes the lesion with an inflated balloon. (c) Successful postdilation and great angiographic result.
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fig5
The angiogram showed a hazy lesion within the mid RCA as the likely culprit with moderate ISR in the proximal vessel (Figure 5(a)). Next we advanced a 2.0 x 15 mm compliant balloon halfway protruding from the GuideLiner and inflated the balloon at 8 atm (Figure 5(b)). This allowed the GuideLiner to pass the proximal stented segment and allow for postdilation of the stented segmented (Figure 5(c)).