Author + information
- Received July 24, 2018
- Revision received December 10, 2018
- Accepted December 12, 2018
- Published online March 18, 2019.
- Takamasa Tanaka, MDa,
- Atsunori Okamura, MDa,∗ (, )
- Katsuomi Iwakura, MDa,
- Mutsumi Iwamoto, MDa,
- Hiroyuki Nagai, MDa,
- Tomohiro Yamasaki, MDa,
- Akinori Sumiyoshi, MDa,
- Kota Tanaka, MDa,
- Koichi Inoue, MDa,
- Yasushi Koyama, MDa,
- Tohru Masuyama, MDb,
- Masaharu Ishihara, MDb and
- Kenshi Fujii, MDa
- ↵∗Address for correspondence:
Dr. Atsunori Okamura, Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan.
Objectives This study sought to compare the procedural outcomes of percutaneous coronary intervention for chronic total occlusion between the periods before and after introduction of 3-dimensional (3D) wiring.
Background Previously, we reported a 3D wiring method by which the operator can construct real-time mental 3D images from 2 perpendicular angles of X-ray system monitor during percutaneous coronary intervention for chronic total occlusion.
Methods A total of 137 chronic total occlusion lesions that could not be passed by tapered soft wires in our hospital between 2012 and 2017 were retrospectively enrolled in the study.
Results Overall success rate was significantly higher in the 3D wiring group (n = 69) than the non-3D wiring group (n = 68) (98% vs. 90%, respectively; p = 0.027). In the primary antegrade cases, the first antegrade approach time was significantly shorter in the 3D wiring group than the non-3D wiring group (42 ± 29 vs. 30 ± 16 min, respectively; p = 0.01). In cases where the antegrade approach was continued throughout the procedure, the success rate was significantly higher in the 3D wiring group than the non-3D wiring group (100% vs. 89.2%, respectively; p = 0.033). Vessel perforation by the antegrade wire tended to be lower in the 3D wiring group than the non-3D wiring group (1% vs. 11%, respectively; p = 0.055).
Conclusions 3D wiring enables accurate guidewire control, which improves the success rate of antegrade wiring and reduces the antegrade procedure time, resulting in improvement of the overall success rate.
Dr. Okamura has received speaking fees from Terumo Corp. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 24, 2018.
- Revision received December 10, 2018.
- Accepted December 12, 2018.
- 2019 The Authors