Comparison of magnetic wire navigation with the conventional wire technique for percutaneous coronary intervention of chronic total occlusions: a randomised, controlled study

Christian Roth, Rudolf Berger, Sabine Scherzer, Lisa Krenn, Clemens Gangl, Daniel Dalos, Georg Delle-Karth, Thomas Neunteufl

Research output: Journal article (peer-reviewed)Journal article

4 Citations (Scopus)

Abstract

Wire crossing of a chronic total coronary occlusion (CTO) is time consuming and limited by the amount of contrast agent and time of radiation exposure. Magnetic wire navigation (MWN) might accelerate wire crossing by maintaining a coaxial vessel orientation. This study compares MWN with the conventional approach for recanalization of CTOs. Forty symptomatic patients with CTO were randomised to MWN (n = 20) or conventional approach (n = 20) for antegrade crossing of the occlusion. In the intention-to-treat analysis, MWN showed a shorter crossing time (412 versus 1131 s; p = 0.001), and, consequently, lower usage of contrast agent (primary endpoint 42 versus 116 ml; p = 0.01), and lower radiation exposure (dose-area product: 29 versus 80 Gy*cm(2); p = 0.002) during wire crossing compared to the conventional approach. Accordingly, in the per-protocol analysis, the wire-crossing rate was, in trend, higher using the conventional approach (17 of 31) compared to MWN (9 of 28; p = 0.08). The use of MWN for revascularisation of CTOs is feasible and reduces crossing time, use of contrast agent, and radiation exposure. However, due to a broader selection of wires, the conventional approach enables wire crossing in cases failed by MWN and seems to be the more successful choice.

Original languageEnglish
Pages (from-to)1266-1276
Number of pages11
JournalHeart and Vessels
Volume31
Issue number8
DOIs
Publication statusPublished - 1 Aug 2016

Keywords

  • Aged
  • Austria
  • Chronic Disease
  • Contrast Media
  • Coronary Angiography/methods
  • Coronary Occlusion/diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention/methods
  • Prospective Studies
  • Treatment Outcome

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