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Thrombus formation on guide wires during routine PTCA procedures: a scanning electron microscopic evaluation.
François Gobeil1, Carl Juneau, Sylvain Plante
1Quebec Heart Institute, Laval. gobeil@angiogene.com
The Canadian Journal of Cardiology
|March 22, 2002
Summary
Thrombogenicity of angioplasty guide wires varied significantly, with 48% showing thrombus. Phosphorylcholine-coated wires demonstrated superior resistance to thrombus formation, indicating potential clinical benefits.
Area of Science:
- Cardiovascular Interventions
- Biomaterials Science
- Medical Device Thrombogenicity
Background:
- Catheter and guide wire coatings aim to reduce thrombus formation.
- Limited data exists on the thrombogenicity of 0.014" angioplasty guide wires and their coatings.
Purpose of the Study:
- To evaluate and compare the thrombogenicity of five distinct 0.014" guide wire types used in coronary angioplasty.
Main Methods:
- Five guide wire types were assessed in 50 consecutive angioplasty procedures.
- Distal guide wire sections were examined using scanning electron microscopy.
- Thrombus formation was categorized as none, limited, or significant.
Main Results:
- 48% of guide wires exhibited significant thrombus, 18% limited, and 34% none.
- Thrombogenicity varied greatly: Guidant (80% significant thrombus), Schneider (69%), Scimed (38%), Cordis (25%).
- Biocompatibles phosphorylcholine-coated guide wires showed no thrombus formation (P<0.0001).
Conclusions:
- Significant thrombus formation on angioplasty guide wires is common (48% of cases).
- Coating resistance to thrombus formation differs substantially among guide wires.
- Phosphorylcholine coatings appear most effective in preventing thrombus; clinical implications require further study.