Successful use of the hearttrail III catheter as a stent delivery catheter following failure of conventional techniques

The Terumo 'five in six' system involves insertion of an extra length, 5 Fr Terumo guide catheter (Heartrail, Terumo) into a standard 6 Fr guide catheter so that the tip protrudes beyond the 6 Fir guide. This system increases backup support and has been used successfully to advance balloon catheters across chronic total occlusions. We describe the use of this system to facilitate extra deep intubation, enabling distal stent delivery beyond proximal points of obstruction that had been unsuccessful using more conventional techniques. (c) 2008 Wiley-Liss, Inc.