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Aorta ostial lesions leads to difficulties in stent implantation. In floating wire technique; guiding catheter is placed to ostium and the main guidewire is advanced through the lesion. Then, for preventing deep engagement; a second wire is placed into the aortic root after guiding catheter is backed out of the ostium. We are using floating wire technique especially for right coronary ostial lesions. In literature, there are no long term data for floating wire technique at right aorta ostial lesions.
126 patients were recruited to the study. All of these patients had critical right coronary aorta ostial lesion on coronary angiography. Floating wire technique was performed to 64 patients and single wire technique was performed to 62 patients. Two group were compared to each other in terms of lesion properties (minimal lumen diameter, reference vessel diameter, mean lesion length and minimal lümen diameter after percutaneous intervention), number and mean length of coronary stents, mean volume of opaque material, mean fluoroscopy time and procedure time. Additionally 1 year clinical follow up results (angina and myocardial infarction frequency and need for revascularisation) were compared between two groups. Control coronary angiography were performed to 60 patients from each group and revascularisation was performed to the restenotic lesions which makes over % 50 of narrowing. Student -t- test was performed for statistical analysis.
There is no statistically significant difference in terms of lesion properties between two groups. In floating wire group; mean stent length (18 ± 5 vs 23 ± 6;p= 0.01) , number of stents (67 vs 75; p<0.05), mean procedure time(22 ± 15 vs 32 ± 16; p=0.01), mean opaque volume (90 ± 18 vs 135 ± 20; p=0.01) and mean fluoroscopy time (6,8 ± 4 vs 8,2 ± 5;p<0.05) were significantly lower than single wire group. At one year clinical follow up; one patient from each group had myocardial infarction and no mortality was observed. In floating wire group; number of patients who experienced angina (7 vs 13; p<0.05) and need for revascularisation (12 vs 18; p<0.05) were significantly lower than single wire group.
Floating wire technique at right coronary ostial lesions provides significant advantage over single wire technique. t 1 year follow up; angina frequency and need for revascularization are significantly lower in floating wire group.