Tip Detection Method Using the New IVUS Facilitates the 3-Dimensional Wiring Technique for CTO Intervention.
JACC Cardiovasc Interv
; 13(1): 74-82, 2020 01 13.
Article
en En
| MEDLINE
| ID: mdl-31838108
OBJECTIVES: This study assessed the efficacy of the tip detection method during intravascular ultrasound (IVUS)-based 3-dimensional (3D) wiring with a new chronic total occlusion (CTO)-specific IVUS system (AnteOwl IVUS [AO-IVUS]) for CTO percutaneous coronary intervention (PCI). BACKGROUND: The study developed angiography-based 3D wiring for CTO-PCI. Previously, the authors produced a short-tip CTO-specific IVUS system (Navifocus WR IVUS [Navi-IVUS]), which has been upgraded into the AO-IVUS system by adding a pullback transducer system for IVUS-based 3D wiring. METHODS: A CTO lesion 20 mm in length composed of 2.5% agar was experimentally inserted into the coronary artery of a beating heart model. The target (a microcatheter with a 0.6-mm lumen) was placed in the distal part of the CTO lesion. IVUS-guided wiring was performed to insert the guidewire into the target using the Navi-IVUS and then using the AO-IVUS 8 times each. In wiring with AO-IVUS, the IVUS-based 3D wiring using the tip detection method was performed. The crossing time and the number of punctures to the target were calculated. RESULTS: The crossing time was significantly shortened and the number of punctures was significantly reduced in AO-IVUS-based wiring compared with Navi-IVUS-based wiring (median crossing time 80.5 s [interquartile range: 44.0 to 112.3 s] vs. 333.0 s [interquartile range: 88.8 to 790.0 s]; p = 0.036; median 1.0 puncture [interquartile range: 1.0 to 2.0 punctures] vs. 24.0 punctures [interquartile range: 5.8 to 52.5 punctures]; p = 0.001). CONCLUSIONS: The tip detection method enables the authors to easily perform the IVUS-based 3D wiring, and the new CTO IVUS system will facilitate this method in clinical practice.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cateterismo Cardíaco
/
Ultrasonografía Intervencional
/
Vasos Coronarios
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Oclusión Coronaria
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Intervención Coronaria Percutánea
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Catéteres Cardíacos
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Aged
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Female
/
Humans
Idioma:
En
Revista:
JACC Cardiovasc Interv
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Estados Unidos