title: Magnetic-guided percutaneous coronary intervention enabled by two-dimensional guidewire steering and three-dimensional virtual angioscopy: initial experiences in daily clinical practice.
abstract: OBJECTIVE
  Percutaneous coronary intervention (PCI) has been broadly established and often includes highly complex stenoses that require difficult navigation. The purpose of this study is to assess the feasibility of a new magnetic navigation system (MNS) to enable intracoronary guidewire deployment and PCI in daily clinical practice and to compare the 2D guidance to the virtual 3D angioscopy feature.
  
  
  RESULTS
  We included 30 consecutive patients (pt) in whom 36 coronary arteries were PCI targets. Patients were randomized to guidewire steering by either 2D guidance or virtual 3D angioscopy (33%). In 31/36 (86%) interventions the MNS guidewire successfully passed the culprit stenosis and the procedure was accomplished by PCI. In 5/30 pt an MNS multivessel intervention was performed. Three of 5 unsuccessful procedures failed due to an unsuccessful recanalization of a subtotal chronic occlusion including 1 pt who required surgical intervention. In 2/36 procedures the magnetic guided intervention was performed effectively after prior conventional failure related to complex anatomy. The contrast medium amount needed to position the magnetic guidewire was 60 +/- 101 mL in 2D accomplished interventions vs. 14 +/- 15 mL in 3D procedures (p < 0.05). In 3 pt the MNS did not harm the implanted pacemaker or defibrillator system.
  
  
  CONCLUSIONS
  Magnetic guided PCI is useful in selected patients. In our experience, success is less likely in evidence of a subtotal occlusion.
authors.affiliation: Department of Cardiology, Center of Cardiovascular Medicine, Bad Neustadt, Germany. MAE.Schneider@t-online.de
authors.forename: Michael A E
authors.initials: MA
authors.lastname: Schneider
authors.forename: Franz V
authors.initials: FV
authors.lastname: Hoch
authors.forename: Hans
authors.initials: H
authors.lastname: Neuser
authors.forename: Jürgen
authors.initials: J
authors.lastname: Brunn
authors.forename: Marcus L
authors.initials: ML
authors.lastname: Koller
authors.forename: Frank
authors.initials: F
authors.lastname: Gietzen
authors.forename: Rainer
authors.initials: R
authors.lastname: Schamberger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kerber
authors.forename: Burghard
authors.initials: B
authors.lastname: Schumacher
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017546:Angioscopy; D003287:Contrast Media; D017023:Coronary Angiography / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D014584:User-Computer Interface
chemical_list: D003287:Contrast Media