| Use of a microcatheter in a telescopic system to reach difficult targets in complex congenital heart disease. | |
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MedLine Citation:
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PMID: 19309713 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Some lesions can be very difficult to reach, especially if acute angles and/or multiple turns "protect" access. Once reached, the guiding system needs to give sufficient support for balloons or stents to be deployed. METHODS: A "telescopic" system was created consisting of: (1) a microcatheter with guidewire. This system fits into any catheter allowing a 0.035 inch wire. (2) a 4Fr "delivery" catheter. (3) If sharp angles were encountered, the 4Fr catheter was deployed through a 6Fr or larger angulated guiding sheath. This was cut-off 15 cm out of the groin and re-valvulated with a standard short introducer sheath. PATIENTS AND RESULTS: Since 2004, 89 microcatheter telescopic systems were used during a 4-year period in 1,225 procedures (7.3%). The technique allowed probing with a floppy steerable and exchangeable guidewire, securing any gained position as well as exchanges with a stiffer guide wire if required. Procedures where the telescopic system was effective included: complex stenoses e.g. aortopulmonary collaterals (n = 21), tortuous ducts (n = 9), anterograde balloon dilation of critical aortic stenosis (n = 8) and crossing Blalock Taussig shunts (n = 3). Once in place, the telescopic system allowed delivery of embolic material (n = 38), balloon angioplasty (n = 21), stent deployment (n = 23), fulguration of pulmonary valve (n = 1) or introduction of medication (n = 1). The interventionalists felt that using the telescopic system had reduced fluoroscopy and procedure time. CONCLUSIONS: The microcatheter-telescopic system is an invaluable tool to reach difficult targets and allows exchange for suitable guidewires permitting balloons, stents, embolisation material or radiofrequency energy to be deployed in such targets. This approach has become our standard when dealing with difficult targets protected by a tortuous route. |
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Authors:
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Stephen C Brown; Derize E Boshoff; Benedicte Eyskens; Luc Mertens; Marc Gewillig |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 73 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-30 Completed Date: 2009-05-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 676-81 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Wiley-Liss, Inc. |
Affiliation:
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Paediatric Cardiology, University of the Free State, Bloemfontein, South Africa. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Angioplasty, Transluminal, Percutaneous Coronary / instrumentation Balloon Dilatation / instrumentation Child Child, Preschool Coronary Angiography / instrumentation Embolization, Therapeutic / instrumentation Equipment Design Heart Catheterization / instrumentation* Heart Defects, Congenital / radiography, therapy* Humans Infant Infant, Newborn Radiography, Interventional / instrumentation Stents Time Factors Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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