Guidewire navigation in coronary artery stenoses using a novel magnetic navigation system: First clinical experience
- 17 February 2006
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 67 (3) , 356-363
- https://doi.org/10.1002/ccd.20642
Abstract
The objective of this study was to investigate the efficacy of guidewire navigation across coronary artery stenoses using magnetic navigation system (MNS) versus conventional navigation. The MNS is a novel option to facilitate access to target lesions, particularly in tortuous vessels. In an experimental study using a challenging vessel phantom, magnetic‐navigated guidewire passage has been reported to reduce fluoroscopy and procedure time significantly. Both magnetic and manual guidewire navigation were attempted in 21 consecutive diseased coronary arteries. The study endpoint was defined as an intraluminal wire position distal to the stenosis. Procedural success was defined as successful guidewire passage without procedural events. Procedure time, amount of contrast, fluoroscopy time, and radiation dose/area product (DAP) were evaluated. There were no procedural events related to either guidewire. Although the lesions attempted had relatively simple and straightforward characteristics, significantly shorter procedure and fluoroscopy time were observed for manual guidewire navigation compared to MNS (median, 40 vs. 120 sec, P = 0.001; 38 vs. 105 sec, P = 0.001, respectively). Contrast amount and DAP were higher in MNS than in conventional method (median, 13 vs. 9 ml, P = 0.018; 215 vs. 73 Gym2, P = 0.002, respectively). The magnetic wire did not cross in two vessels. Guidewire navigation using MNS presented a novel, safe, and feasible approach to address coronary artery lesions. Clinical studies are needed to evaluate the potential benefit of the MNS in more complex coronary lesions and tortuous anatomy.Keywords
This publication has 19 references indexed in Scilit:
- Emergency Coronary Artery Bypass Surgery in the Contemporary Percutaneous Coronary Intervention EraCirculation, 2002
- Real-Time Quantification and Display of Skin Radiation During Coronary Angiography and InterventionCirculation, 2001
- Restenosis, reocclusion and adverse cardiovascular events after successful balloon angioplasty of occluded versus nonoccluded coronary arteries: Results from the multicenter american research trial with cilazapril after angioplasty to prevent transluminal coronary obstruction and restenosis (MARCATOR)Journal of the American College of Cardiology, 1996
- Coronary angioplasty of chronic total occlusions with bridging collateral vessels: immediate and follow-up outcome from a large single-center experienceJournal of the American College of Cardiology, 1995
- In‐hospital outcome of percutaneous transluminal coronary angioplasty for long lesions and diffuse coronary artery diseaseCatheterization and Cardiovascular Diagnosis, 1995
- Clinical and lesion morphologic determinants of coronary angioplasty success and complications: Current experienceJournal of the American College of Cardiology, 1995
- Determinants of success of coronary angioplasty in patients with a chronic total occlusion: a multiple logistic regression model to improve selection of patients.Heart, 1993
- Lesion morphology and coronary angioplasty: Current experience and analysisJournal of the American College of Cardiology, 1992
- Balloon angioplasty of chronic total coronary artery occlusions: What does it cost in radiation exposure, time, and materials?Catheterization and Cardiovascular Diagnosis, 1992
- Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group.Circulation, 1990