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Guidewire and microcatheter utilization patterns during antegrade wire escalation in chronic total occlusion percutaneous coronary intervention: Insights from a contemporary multicenter registry
- Source :
- Catheterization and Cardiovascular Interventions. 89:E90-E98
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Objectives We sought to describe contemporary guidewire and microcatheter utilization for antegrade wire escalation (AWE) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background Equipment utilization for AWE has been variable and evolving over time. Methods We examined device utilization during 694 AWE attempts in 679 patients performed at 15 experienced US centers between May 2012 and April 2015. Results Mean age was 65.6 ± 9.7 years, and 85% of the patients were men. Successful wiring occurred in 436 AWE attempts (63%). Final technical and procedural success was 91% and 89%, respectively. The mean number of guidewire types used for AWE was 2.2 ± 1.4. The most frequently used guidewire types were the Pilot 200 (Abbott Vascular, 56% of AWE procedures), Fielder XT (Asahi Intecc, 45%), and the Confianza Pro 12 (Asahi Intecc, 28%). The same guidewires were the ones that most commonly crossed the occlusion: Pilot 200 (36% of successful AWE crossings), Fielder XT (20%), and Confianza Pro 12 (11%). A microcatheter or over-the-wire balloon was used for 81% of AWE attempts; the Corsair microcatheter (Asahi Intecc) was the most commonly used (44%). No significant association was found between guidewire type and incidence of major adverse cardiac events (MACE). Conclusions Our contemporary, multicenter CTO PCI registry demonstrates that the most commonly used wires for AWE are polymer-jacketed guidewires. "Stiff" and polymer-jacketed guidewires appear to provide high crossing rates without an increase in MACE or perforation, and may thus be considered for upfront use. © 2016 Wiley Periodicals, Inc.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Perforation (oil well)
Percutaneous coronary intervention
General Medicine
030204 cardiovascular system & hematology
Balloon
medicine.disease
Surgery
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Coronary occlusion
Conventional PCI
Occlusion
medicine
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Cardiology and Cardiovascular Medicine
business
Mace
Subjects
Details
- ISSN :
- 15221946
- Volume :
- 89
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi...........d6456c1b36afe4a4d0af41168fe5898e