Vibrational angioplasty and hydrophilic guidewires in the treatment of chronic total coronary occlusions.
OBJECTIVE
To study the efficacy and safety of vibrational angioplasty versus hydrophilic guidewires for recanalizing chronic total occlusions (CTOs) of the coronary arteries.


METHODS
In a retrospective study, 99 patients with old (>3 months) CTOs resistant to conventional techniques were treated either with vibrational angioplasty (group A, n = 72) or 0.014-inch hydrophilic guidewires (group B, n = 27). The selection of the technique (vibrational angioplasty or hydrophylic guidewires) was dependent only upon device availability. A variety of guidewires were employed in conjunction with vibrational angioplasty.


RESULTS
The crossing success rates in groups A and B were 86.1% (62/72) and 55.5% (15/27) (p < 0.05), with final procedural success rates of 75% (54/72) and 44.4% (12/27) (p < 0.01), respectively. The main reasons for failure were inability to cross the lesion with a guidewire (10/18 in group A and 12/15 in group B) and large dissections resulting in vessel closure (2/18 in group A and 2/15 in group B). Three major complications were seen, 2 in group A and 1 in group B. Three vessel perforations were reported in group A. Both techniques needed prolonged fluoroscopy times.


CONCLUSIONS
Vibrational angioplasty was more successful in treating CTOs compared to hydrophilic guidewires and had similar complication rates (most without clinical sequelae).
Michalis
L K
LK
Department of Cardiology, University Hospital of Ioannina, Greece. Lmichalis@compulink.gr
Rees
M R
MR
Davis
J A
JA
Pappa
E C
EC
Katsouras
C
C
Goudevenos
J
J
Sideris
D A
DA
D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*