{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T07:46:16Z","timestamp":1776498376700,"version":"3.51.2"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":107,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Cardiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Background and Aims<\/jats:title>\n Coronary artery ectasia poses unique challenges during primary percutaneous coronary intervention for ST\u2010segment elevation myocardial infarction (STEMI), owing to thrombus burden and vascular tortuosity. This case demonstrates successful reperfusion using a flexible, hydrophilic\u2010coated guide catheter extension (GuidePlus, Nipro, Osaka, Japan).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 45\u2010year\u2010old man with inferior STEMI had complete occlusion of a severely ectatic (6.5\u2009mm, 1.8\u00d7 reference) and tortuous RCA with a \u2018shepherd\u2019s crook\u2019 morphology. The conventional GuideLiner failed to cross. GuidePlus, a soft and hydrophilic extension, enabled thrombus aspiration and intracoronary urokinase (240,000\u2009IU) delivery. A 4.0 \u00d7 28\u2010mm drug\u2010eluting stent (Ultimaster, Terumo) was deployed and postdilated (5.0\u2010mm NC balloon).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The GuidePlus enabled smooth navigation, direct aspiration and thrombolysis. Final angiography confirmed TIMI Grade 3 flow with minimal residual thrombus. The patient was discharged uneventfully and has remained event\u2010free with dual antiplatelet therapy (aspirin and prasugrel).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n GuidePlus offers excellent flexibility and crossability for managing STEMI in ectatic and tortuous arteries when conventional devices fail.<\/jats:p>\n <\/jats:sec>","DOI":"10.1155\/cric\/5644505","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T07:14:12Z","timestamp":1776496452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of STEMI in an Ectatic and Tortuous Right Coronary Artery Using a Flexible Guide Catheter Extension: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6381-2247","authenticated-orcid":false,"given":"Yasuyuki","family":"Toyama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Okabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.67.1.134"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0300-8932(03)76902-4"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12354"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2018.05.019"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-015-0334-4"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.03.069"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-017-0527-0"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6148470"}],"container-title":["Case Reports in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/5644505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cric\/5644505","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/5644505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T07:14:13Z","timestamp":1776496453000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cric\/5644505"}},"subtitle":[],"editor":[{"given":"Karuna","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cric\/5644505"],"URL":"https:\/\/doi.org\/10.1155\/cric\/5644505","archive":["Portico"],"relation":{},"ISSN":["2090-6404","2090-6412"],"issn-type":[{"value":"2090-6404","type":"print"},{"value":"2090-6412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2024-12-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5644505"}}