title: The use of soft and flexible guidewires in the treatment of chronic total coronary occlusions by activated guidewire angioplasty.
abstract: Activated guidewire angioplasty (AGA) is a new technique which has been designed to assist in angioplasty of total occlusions. The purpose of this study was to determine the safety and efficacy of using flexible relatively soft guidewires (floppy wires) in conjunction with this technique and also to determine the predictors of lesion crossing and final success by this technique in patients with chronic total coronary occlusions. 73 patients with 73 chronic total coronary occlusions in whom coronary angioplasty using conventional techniques had failed were treated with AGA using floppy guidewires. The success of crossing these lesions was 65.7% (48/73) resulting in a final angioplasty success of 56.1% (41/73). Angioplasty success was reduced compared with crossing success in seven arteries in which complications occurred during balloon angioplasty. Multiple stepwise logistic regression analysis identified the location of the occlusion (right coronary artery, p = 0.005) as independent predictor of crossing success of this technique and the male gender (p = 0.03), the duration of occlusion (p = 0.05), the lesion length (p = 0.01) and the location of the occlusion (right coronary artery, p = 0.02) as independent predictors of final procedural success of the method.
authors.affiliation: Department of Clinical Radiology, Bristol Royal Infirmary, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Rees
authors.forename: L K
authors.initials: LK
authors.lastname: Michalis
authors.forename: E C
authors.initials: EC
authors.lastname: Pappa
authors.forename: S
authors.initials: S
authors.lastname: Loukas
authors.forename: J A
authors.initials: JA
authors.lastname: Goudevenos
authors.forename: D A
authors.initials: DA
authors.lastname: Sideris
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002908:Chronic Disease; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D012737:Sex Factors; D017211:Treatment Failure; D016896:Treatment Outcome