Masoud Sajjadi MD - Fellowship of Interventional Cardiology

1. Guidion
By : Masoud Sajjadi
MD , Fellowship of Interventional Cardiology

2. BEST Technique in Strengthening Guiding Catheter
Practical Handbook of Advanced Interventional Cardiology
Tips and Tricks . 2014

3.  Second Angioplasty Wire Can be advanced Parallel to the
first one
 It Straightens the Tortuous Vessel and Provides Better
Support for Device Tracking
 Second wire in a Side Branch can be very useful in
“Anchoring” the GC ( Second wire in the LCX when
Dilating an LAD Lesion ) ,This provides for better “backup”
 If one Extra wire Does not help maybe Two or Three
Buddy wires may help to Advance any Devices
Stabilizing GC with the “Buddy” wire Technique
Practical Handbook of Advanced Interventional Cardiology
Tips and Tricks . 2014

4.  When working with an Unstable GC , Second Small
Balloon ( 1.5– 2.5 mm Diameter) can be inserted in a
Small Proximal Branch and Inflated at 2–5 atm, in order
to Anchor the GC ( without letting the guide Back out )
Anchor Balloon Technique
Practical Handbook of Advanced Interventional Cardiology
Tips and Tricks . 2014

5.  Therefore, GCs with Relatively Simple Curves
(Amplatz, MP, EBU) are Probably Safer and Better suited
for this Technique
 Disengaging the GC from the Coronary Ostium should be
Performed only after the Sheath is Retrieved away from
it, Probably to the Descending Aorta, with the GC Fixed
in Place
 ( Larger Fr size will Give more Support ) and the Height
of the Patient Taller Patients will Require Longer Sheaths
Stabilizing GC with Long Sheath
Practical Handbook of Advanced Interventional Cardiology
Tips and Tricks . 2014

6.  When a Lesion Could not be Crossed by a Balloon or
Stent in the Regular 6-Fr system, the Five-in-Six System
could be tried (“Mother in Child”)
Strengthening the GC with Another Catheter
Practical Handbook of Advanced Interventional Cardiology
Tips and Tricks . 2014

7. Guidion
 This allows advancement of a Device through a Tortuous,
Angulated, or Calcified Proximal Segment without
Getting Exposed to Friction from the Vessel Wall
 is Contraindicated in Vessels that are <2.5 mm
 Avoiding Stents >4 mm diameter
Strengthening the GC with Another GC
Practical Handbook of Advanced Interventional Cardiology
Tips and Tricks . 2014

8. Guidion Structure

9. Guidion Characterestics