Use of 'Guideliner' Catheter to Overcome Failure of Delivery of Absorb™ Bioresorbable Vascular Scaffold in Calcified Tortuous Coronary Lesions: Technical Considerations in 'Real World Patients'

In our series of 177 real world patients (223 lesions) who underwent Absorb Bioresorbable Vascular Scaffold (BVS) implantation, 78 lesions were calcified and tortuous lesions. In four of these, despite adequate lesion bed preparation, appropriate guiding catheter support and use of buddy wires, the BVS failed to track through the proximal calcified and tortuous coronary anatomy (CTCA). "Guide Liner" catheter (GLC) had to be finally used to resuccessfully deliver and implant BVS to the lesion site. We report for the first time four cases of use of guideliner catheter to successfully overcome failed delivery of BVS to the lesion site through proximal CTCA, calcified and tortuous coronary artery (CTCA) lesions treated with Absorb™ BVS. Because the BVS is a large profile device, certain difficulties were encountered in delivering it through the GLC, which were finally overcome. We have therefore discussed the 'lessons and learnt' and "salient practice points" to enable successful delivery of BVS through the GLC.