Improved success rate of percutaneous transluminal graft and coronary angioplasty with the EL gamal guiding catheter

In the period between October 1980 and December 1982 we evaluated the outcome of percutaneous transluminal graft and coronary angioplasty when a Judkins type guiding catheter (J gc) was initially used, but the lesion could not be passed and a subsequent attempt was made with the El Gamal guiding catheter (EG gc). Seven of twelve attempts to dilate stenotic coronary artery bypass grafts failed. The EC gc was tried in six, five were successfully dilated; one failed. Our initial attempts to dilate a stenosed right coronary artery failed in 16 of 68 attempts. The EG gc was attempted in 14. We successfully dilated ten, two dissections required emergency coronary artery bypass grafting (CABG); two failed. Our initial attempts to dilate a left anterior descending artery stenosis failed in 14 of 109 attempts. Six lesions were passed when the EG gc was tried. Five were successfully dilated, and one acute dissection required emergency CABG; eight failed. The EG gc is useful for transluminal angioplasty of stenosed aortocoronary bypass grafts. It increased the success rate of right coronary artery dilatation from 76-91%, but was of limited use in dilatation of left anterior descending lesions.