Karatasakis Aris, Tarar Muhammad Nauman J, Karmpaliotis Dimitri, Alaswad Khaldoon, Yeh Robert W, Jaffer Farouc A, Wyman R Michael, Lombardi William L, Grantham J Aaron, Kandzari David E, Lembo Nicholas J, Moses Jeffrey W, Kirtane Ajay J, Parikh Manish, Garcia Santiago, Doing Anthony, Pershad Ashish, Shah Alpesh, Patel Mitul, Bahadorani John, Shoultz Charles A, Danek Barbara A, Thompson Craig A, Banerjee Subhash, Brilakis Emmanouil S
VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas.
Columbia University, New York, New York.
Catheter Cardiovasc Interv. 2017 Mar 1;89(4):E90-E98. doi: 10.1002/ccd.26568. Epub 2016 May 17.
We sought to describe contemporary guidewire and microcatheter utilization for antegrade wire escalation (AWE) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Equipment utilization for AWE has been variable and evolving over time.
We examined device utilization during 694 AWE attempts in 679 patients performed at 15 experienced US centers between May 2012 and April 2015.
Mean age was 65.6 ± 9.7 years, and 85% of the patients were men. Successful wiring occurred in 436 AWE attempts (63%). Final technical and procedural success was 91% and 89%, respectively. The mean number of guidewire types used for AWE was 2.2 ± 1.4. The most frequently used guidewire types were the Pilot 200 (Abbott Vascular, 56% of AWE procedures), Fielder XT (Asahi Intecc, 45%), and the Confianza Pro 12 (Asahi Intecc, 28%). The same guidewires were the ones that most commonly crossed the occlusion: Pilot 200 (36% of successful AWE crossings), Fielder XT (20%), and Confianza Pro 12 (11%). A microcatheter or over-the-wire balloon was used for 81% of AWE attempts; the Corsair microcatheter (Asahi Intecc) was the most commonly used (44%). No significant association was found between guidewire type and incidence of major adverse cardiac events (MACE).
Our contemporary, multicenter CTO PCI registry demonstrates that the most commonly used wires for AWE are polymer-jacketed guidewires. "Stiff" and polymer-jacketed guidewires appear to provide high crossing rates without an increase in MACE or perforation, and may thus be considered for upfront use. © 2016 Wiley Periodicals, Inc.
我们试图描述在慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）期间，用于顺行导丝升级（AWE）的当代导丝和微导管的使用情况。
随着时间的推移，AWE的设备使用情况一直变化不定且不断发展。
我们研究了2012年5月至2015年4月期间在美国15个经验丰富的中心对679例患者进行的694次AWE尝试中的设备使用情况。
平均年龄为65.6±9.7岁，85%的患者为男性。436次AWE尝试（63%）成功置入导丝。最终技术成功率和手术成功率分别为91%和89%。用于AWE的导丝类型平均数量为2.2±1.4种。最常用的导丝类型是Pilot 200（雅培血管，占AWE手术的56%）、Fielder XT（朝日英特克，45%）和Confianza Pro 12（朝日英特克，28%）。同样是这些导丝最常穿过闭塞病变：Pilot 200（成功AWE穿过的36%）、Fielder XT（20%）和Confianza Pro 12（11%）。81%的AWE尝试使用了微导管或钢丝外球囊；Corsair微导管（朝日英特克）是最常用的（44%）。未发现导丝类型与主要不良心脏事件（MACE）发生率之间存在显著关联。
我们当代的多中心CTO PCI注册研究表明，AWE最常用的导丝是聚合物涂层导丝。“硬”导丝和聚合物涂层导丝似乎能提供较高的穿过率，且不会增加MACE或穿孔的发生率，因此可考虑作为首选使用。©2016威利期刊公司
