• Ammar Jumah, Michael Fana, Hassan Aboul-Nour, Abdalla Jamal Albanna, Owais Khadem Alsrouji, and Alex Chebl.
• Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA. Electronic address: ajumah1@hfhs.org.
• World Neurosurg. 2024 Aug 1; 188: 151915-19.

BackgroundNeuroendovascular procedures can be challenging due to severe angulation of the cervical and cranial vessels. Typical approaches for overcoming this tortuosity involve using multiple telescoping catheter systems to provide proximal support for therapeutic device delivery. Although this approach can be effective, it does have limitations.MethodsWe describe the utility of the Guidezilla (Boston Scientific, Natick, Massachusetts, USA) guide extension catheter, a device designed for coronary interventions, in the treatment of 3 patients undergoing neuroendovascular procedures.ResultsIn these 3 cases, the decision to use a guide extension catheter varied but was mainly due to severe tortuosity, heavy calcifications, and failure to introduce stents into distal locations.ConclusionsAlthough helpful in overcoming challenging anatomy, the Guidezilla guide extension catheter should be used with caution when used as a bailout device.Copyright © 2024 Elsevier Inc. All rights reserved.

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