The general approach to TR and TF intervention at our institution is to attempt PCI with conventional guide support, and to use a GuideLiner only in those cases where it became difficult or not feasible ResultsĪmong 146 TRIs performed during the study period, 22 cases (15%) required use of the GuideLiner support catheter during TRI. Among these 146 TRIs, 22 cases (15%) required use of the GuideLiner support catheter. During that timeframe, 146 of these cases were TRI, which comprise the study cohort. We hypothesized that cases requiring the use of a GuideLiner catheter would have a higher prevalence of proximal angle and lesion angle tortuosity, and that GuideLiner use would be associated with high rates of procedural success and minimal need for crossover to a TF approach.Ī total of 1292 PCIs were performed between August 2010 and June 2012 at the University of California, Davis Medical Center. In this study, we characterized the procedural and angiographic characteristics of cases where GuideLiner use facilitated successful TRI. However, no prior study has examined the utility and predictors of GuideLiner use as an adjunctive tool for TRI. Early reports demonstrated successful application of this catheter extension for complex TF coronary interventions including vein and LITA grafts,. The GuideLiner catheter (Vascular Solutions, Minneapolis, MN) is a novel “mother and child” rapid exchange atraumatic guide catheter extension that allows deep vessel intubation with minimal trauma to the native coronary artery. With many new operators adopting radial catheterization and TRI, improved techniques to facilitate successful completion of the procedure could have significant advantages. More aggressive radial-specific guides can also be used, but these may also result in proximal vessel injury. However, most guide catheters are designed for support at the coronary ostia and such maneuvers can traumatize the target coronary artery. One technique to overcome lack of guide catheter support includes deep intubation of the guide catheter. Since most guide catheters were also designed for a TF approach, they may provide less backup support and coaxial alignment for TRI. As a result, less guide backup force is generated. Specifically, guide catheters advanced from the right radial artery often approach the coronary ostia from a vertical downward approach, which excludes the aortic arch. ĭuring trans-radial cardiac catheterization, the anatomic and geometric characteristics of the ascending aorta relative to the catheter differ significantly from TF angiography. Additionally, anatomic variations and lack of guide catheter support increase the technical complexity of TRI. Barriers to TRI include a steep initial learning curve and time required to gain proficiency at TRI. Although TRI is increasingly common, it currently represents < 10% of all PCIs in the USA. Vascular Solutions established its revenue guidance for 2014 before the preliminary injunction so Vascular Solutions is maintaining its sales guidance for the year.Transradial coronary intervention (TRI) is associated with significantly reduced rates of bleeding and access site related complications compared to the transfemoral (TF) approach. A federal circuit ruling recently reversed that injunction costs associated with that patent infringement case and other legal expenses contributed to the reduced guidance figures for the rest of 2014.
Vascular Solutions won a temporary injunction over patent infringement issues with Boston Scientific's Guidezilla guide extension catheter. GuideLiner sales also benefited because a competing catheter from Boston Scientific was off the market due to a preliminary injunction issued in December by the U.S. First-quarter sales of the company's GuideLiner catheter, one of its principal products, rose 40 percent as the company successfully introduced the product in Japan. Sales hit the midpoint of its expected quarterly sales range of $29.5 million to $30.5 million. The company expects its earnings for the year to be between 71 and 75 cents per share, a 12 percent increase over the 65 cents per share it reported for all of 2013. Overall net income for the quarter was $2.8 million or 17 cents per share, up from $2.1 million or 13 cents per share in the first quarter last year.īut Vascular Solutions said it has revised earnings guidance for 2014 due to higher-than-expected legal costs for the year.
product sales rose 14 percent to $25 million while international sales grew faster - up 18 percent to $4.8 million. Vascular Solutions Inc.'s first-quarter revenue grew 15 percent to a record $29.9 million, the Maple Grove-based maker of products used in coronary and peripheral vascular procedures reported Tuesday.
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