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Case Series
Deep Intubation to Faciltate Coronary Intervention – Next Generation Guide Extension: The Edge of “No Edge”
October 2020
The excellent case reports in this issue of CLD demonstrate the use of deep intubation using the GuideLiner guide extension system (Teleflex) to facilitate complex coronary intervention in the mid and distal right coronary artery (RCA). Indeed, most interventional cardiologists, and especially those who engage in complex, higher-risk, and indicated PCI (CHIP), understand the power of guide extension to facilitate stent delivery through tortuous vessels. Guide extension has become a workhorse device for coronary intervention, because of its ability to facilitate device delivery. Current data suggests that approximately 18% of percutaneous coronary interventions (PCIs) are now done with guide extension (Fischell et al, unpublished data, July 2020). This has become even more crucial as we move to radial interventions, with less guiding catheter backup support. In most cases, the guide extension is used to provide additional backup by advancing the tip of the blunt-ended tubular guide extension system into the proximal to mid portion of a coronary artery, but usually not distally.
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