Magnum wire for balloon recanalization of chronic total coronary occlusions.

A new guidewire (Magnum wire, Schneider) was developed for balloon recanalization of chronic total coronary occlusions. This 0.021-inch solid-steel wire with a floppy tip equipped with a 1-mm diameter "olive" is used like an ordinary guidewire, fits conventional balloon catheters and provides excellent steerability. Magnum wires were used in 50 consecutive chronic total coronary occlusions (mean +/- standard deviation duration 8 +/- 21 months, range 1 day to 10 years; mean length 1.1 +/- 0.8 cm, range 0.2 to 4.0). All occlusions were reached (in 23 right, 18 left anterior descending, 8 left circumflex coronary arteries and 1 diagonal branch) and 30 (60%) were recanalized (1 reoccluded during the procedure, and in 3 patients the Magnum wire did not completely cross the occlusion but enabled the previously impossible passage of a conventional wire). The mean age of the occlusion was 3 +/- 4 months in successful and 17 +/- 33 months in unsuccessful procedures (p = 0.04) and the mean length was 1.1 +/- 0.9 and 1.3 +/- 0.6 cm, respectively (p = 0.4). In 17 patients, conventional techniques had been exhausted before the Magnum wire attempt, which was successful in 8 (47%). In 33 patients the Magnum wire was tried first, with success in 22 (67%). Conventional techniques were subsequently tried in 9 of the 11 failures (none was successful). Of the 38 procedures carried out with a second, improved version of the Magnum wire, 26 (68%) were successful.(ABSTRACT TRUNCATED AT 250 WORDS)