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GUIDEZILLA™ II

Guide Extension Catheter

Powerful Reach. Predictable Performance. GUIDEZILLA™ II Guide Extension Catheter provides additional back-up support and facilitates easy delivery of ancillary devices.

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Product Details

GUIDEZILLA II Guide Extension Catheter creates a smooth pathway for balloon and/or stent delivery by providing greater flexibility and a smooth surface. This is important with complex lesions, calcium, tortuous vessels, and distal lesions. 

Short Hypotube Transition - Optimized for reduced device interaction Radiopaque Helical Collar - Designed for improved strength and visibility Z-Glide™ Hydrophilic Coating - For improved deliverability  Expanded Size Matrix: 6F, 7F, & 8F is 25cm 6F Long is 40cm Short Hypotube Transition - Optimized for reduced device interaction Radiopaque Helical Collar - Designed for improved strength and visibility Z-Glide™ Hydrophilic Coating - For improved deliverability  Expanded Size Matrix: 6F, 7F, & 8F is 25cm 6F Long is 40cm

By supporting the delivery of the interventional devices that are necessary to complete the procedure, GUIDEZILLA II Guide Extension Catheter can benefit the patient and hospital by turning an unsuccessful PCI into a successful PCI.

 

Design Changes

Features

GUIDEZILLA™ Guide Extension Catheter

GUIDEZILLA™ II Guide Extension Catheter

Design Goal
Sizes 6F 6F, 7F, 8F, AND 6F Long Expanded Size Matrix
Guide Segment 25 cm

25 cm on 6F, 7F, 8F

(40 cm on 6F Long)

40 cm 6F Long Designed for TRI
Working Length 145 cm 150 cm

Extra 5 cm of Proximal

Hypotube Shaft

Collar Stainless Steel

Platinum Iridium

Helical Collar

Visibility and Smooth

Device Interaction

Coating Bioslide™ Z-Glide™

New Hydrophilic Coating

Aids Deliverability

Radiopaque

Distal Marker Band

Proximal Marker Band

Distal Marker Band

Radiopaque Collar

Added Visibility
Hypotube Transition 19 mm 6 mm

Optimized to Reduce

Device Interaction

Hub Design

Ergonomic and

Easily Identifiable

Case Study: Utilization of GUIDEZILLA II Guide Extension Catheter in Complex Disease

Patient History

  • Originally presented in a NSTEMI situation
  • Intervention on RCA and Circumflex performed at that time
  • Follow up appointment for elective PCI of the LAD and first Diagonal (D1)

Diagnostic Angiogram

  • Previous stents placed in the RCA and Circumflex are widely patent
  • Disease in LAD and D1 unchanged from previous angiogram
  • Severe vessel overlay and difficulty understanding healthy to healthy
    landing zones (Figure 1)

Figure 1

Anticipated Challenges

Figure 2

  • The physician recognized the severity of the disease and the challenges of delivering interventional devices
  • The decision was made prior to the case to utilize the GUIDEZILLA™ II Guide Extension Catheter for support in delivering various devices

Procedure

  • Due to severe overlay, a selective angiogram utilizing the GUIDEZILLA II Guide Extension Catheter (Figure 2) was performed and demonstrated a > 70% lesion in both the LAD and ostium of D1
  • Pre-dilatation of the diagonal was performed with a PTCA balloon catheter
  • Subsequently, a stent was delivered, landing the proximal aspect in the LAD
  • Proximal Optimization Technique (POT) was performed in the ostium of D1 and proximal LAD with semi- and non-compliant balloons, respectively
  • The SAMURAI™ Guidewire was retracted from D1 and advanced to the distal LAD through the previously placed stent, ensuring luminal access
  • Difficulty introducing a winged balloon was experienced and the GUIDEZILLA II Catheter was reintroduced for support
  • Successful crossing of the stent struts was obtained and the semi‑compliant balloon was inflated
  • Once the balloon was deflated, the GUIDEZILLA II Catheter was advanced across the stent struts through the utilization of the “Inchworm”* technique, allowing easier delivery of a stent (Figure 3)
  • Delivery and inflation of a stent was successful, landing proximally to the previously deployed D1 stent
  • Rewiring of D1 with a second SAMURAI™ Guidewire was performed
  • Delivering a balloon through the stent struts proved difficult, so the GUIDEZILLA™ II Catheter was utilized for additional support
  • Diffuse disease on the initial angiogram was acknowledged by the physician and the decision was made to place a stent from the proximal LAD into the Left Main
  • The GUIDEZILLA II Catheter was used to help facilitate delivery of this stent with the Left Main and LAD portions of the stent post dilated with an NC Balloon
  • To check for optimal stent placement, IVUS was advanced down the LAD
  • The physician acknowledged there were no distal stent edge dissections, excellent stent apposition, full stent expansion, and excellent integrity of the neocorina made at the LAD/D1 bifurcation (Figure 4)
  • The final angiogram demonstrated a widely patent left coronary system (Figure 5)

Figure 3
Figure 4
Figure 5

Key Learning Points

  • GUIDEZILLA II Guide Extension Catheter is an excellent supportive device for delivery of interventional devices
  • There are multiple uses and delivery options for GUIDEZILLA II Guide Extension Catheter
  • IVUS optimization is critical for best patient outcomes
  • ”The “Inchworm” technique involves advancing the GUIDEZILLA II Extension Catheter over a recently deflated balloon for further advancement down the artery

 

Ordering Information

Size GTIN Ref/Catalog Number Compatible Guide Catheter Inner Diameter Outer Diameter
6F 08714729939450 H7493933515060 6F I.D. ≥0.070" (1.78mm) 0.057" (1.45 mm) 0.067" (1.71 mm)
6F LONG (40 cm) 08714729939467 H74939335150610 6F I.D. ≥0.070" (1.78 mm) 0.057" (1.45 mm) 0.067" (1.71 mm)
7F 08714729939474 H7493933515070 6F I.D. ≥0.078" (1.98 mm) 0.063" (1.60 mm) 0.073" (1.86 mm)
8F 08714729939481 H7493933515080 6F I.D. ≥0.088" (2.24 mm) 0.072" (1.83 mm) 0.083" (2.11 mm)

 

Reimbursement & Economic Value

The C-Code used for GUIDEZILLA II Guide Extension Catheter is C1769.

C-Codes are used for hospital outpatient device reporting for Medicare and some private payers. Note: Boston Scientific Corporation is not responsible for correct use of codes on submitted claims; this information does not constitute reimbursement or legal advice.

Assumes inpatient admission for initial diagnostic heart catheterization resulting in decision to intervene with drug-eluting stent.

Note: Unsuccessful outpatient PCIs are eligible for 100% APC payment when modifier 74 is used to indicate the procedure was discontinued, partially reduced, or cancelled after the administration of anesthesia (includes local) per physician discretion for the well being of the patient. Source: FY2017 Inpatient Payment Prospective Final Rule, updated August, 2017 (https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2017-IPPS-Final-Rule-Home-Page.html).


 

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