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Recanalization of chronic coronary occlusions using a new hydrophilic guidewire
T Corcos1, X Favereau, Y Guérin
1Department of Interventional Cardiology, Centre Médico-Chirurgical Parly Grand-Chesnay, Le Chesnay, France.
Insights
The new Crosswire hydrophilic guidewire offers a promising solution for chronic total occlusions, achieving a 79% success rate in difficult angioplasty cases where other guidewires failed.
Area of Science:
- Interventional Cardiology
- Vascular Devices
- Guidewire Technology
Background:
- Chronic total occlusions (CTO) present significant challenges in coronary angioplasty.
- Existing hydrophilic guidewires have limitations for CTO treatment.
- CTO is a major reason for angioplasty failure.
Purpose of the Study:
- To evaluate the efficacy and safety of the new Crosswire hydrophilic guidewire.
- To assess the guidewire's performance in treating CTOs resistant to conventional methods.
Main Methods:
- The Crosswire guidewire (0.014" hydrophilic nitinol) was used in 56 CTOs across 55 patients.
- Recanalization attempts were made after failure with conventional guidewires.
- The guidewire features a shapeable, radiopaque platinum-iridium coiled tip and accommodates low-profile balloon catheters.
Main Results:
- Clinical success was achieved in 79% of the treated chronic total occlusions.
- The Crosswire guidewire demonstrated usefulness in complex CTO cases.
- Two cases of coronary perforation occurred, one necessitating pericardiocentesis.
Conclusions:
- The Crosswire guidewire is a valuable tool for treating challenging chronic total occlusions.
- It offers improved outcomes in cases where conventional guidewires have failed.
- Further investigation into its safety profile, particularly regarding perforation risk, is warranted.
Abstract:
Chronic total occlusion remains a relative contraindication and the main cause of failure of coronary angioplasty. Previously available hydrophilic guidewires had numerous limitations. The Crosswire is a new 0.014" hydrophilic nitinol guidewire which can be accommodated by very-low-profile balloon catheters and has a shapeable and highly radiopaque platinum-iridium coiled tip. This guidewire was used in 55 patients with 56 chronic coronary occlusions in which recanalization by conventional guidewires had failed. Clinical success was 79%. Coronary perforation occurred in two cases, one of them requiring pericardiocentesis for tamponade. These results illustrate the usefulness of this new guidewire in the treatment of chronic total occlusions.