Percutaneous Coronary Intervention Using Crosswire NT in Total Occlusion of Coronary Artery

Abstract

Background and Objectives:Despite marked advances in the design of percutaneous coronary intervention hardware, total occlusion remains associated with a low primary success rate. The most common cause of failure is the inability to cross the lesion with a guidewire. We report the results of a non-randomized singlecenter investigation using a hydrophilic coated guidewire (Crosswire). Subjects and Methods:We analyzed the angiographic results of 92 patients (68 males, 24 females, age 58.8±9.7 years-old) who underwent angioplasty utilizing Crosswire for either total (TIMI flow 1) or subtotal occlusion at Chonnam National University Hospital between December 2000 and July 2001. Results:Clinical diagnoses of the studied subjects revealed 40 cases of acute myocardial infarction, 15 of myocardial infarction, 29 of unstable angina and 8 of stable angina. The primary success rate was 79.3% (73/92), the success rate in total occlusion was 69.0% (40/58), and that of the chronic total occlusion cases among the total occlusion group was 64.3% (18/28). The success rates in the use of Crosswire as the first and second choice were 85.7% and 78.8%, respectively. The abrupt occlusive lesions, complex lesions more than type B2, and presence of collateral circulation were all associated with a lower success rate. Coronary artery perforation occurred in one case. Conclusion:The new nitinol hydrophilic wire, Crosswire, is a safe and effective tool for the recanalization of total occlusive coronary lesion. (Korean Circulation J 2002;32(2):125-130)