Use of the Stereotaxis Niobe magnetic navigation system for percutaneous coronary intervention: results from 350 consecutive patients.
BACKGROUND
The Stereotaxis Niobe magnetic navigation system (MNS; Stereotaxis, St. Louis, MO) facilitates precise vector based navigation of magnetically-enabled guidewires for percutaneous coronary intervention (PCI) by using two permanent magnets located on opposite sides of the patient table to produce a controllable magnetic field. The objective of this study is to describe the results of a large patient series using this system, to compare the results with a historical control group, and to detail the MNS learning curve.


METHODS
We prospectively collected data on 439 lesions in 350 consecutive PCI patients using the MNS predominantly using the radial approach. All data were entered into a customized database to capture the key parameters and then compared with a previously collected stent registry from the same center.


RESULTS
In 410/439 lesions (93%) the wire crossed the lesion successfully using the MNS. Twenty-five of the 35 failures were chronic total occlusions. No wire perforations or dissections occurred in this population. Lesion crossing time was 81 +/- 168 sec (mean +/- SD), and fluoroscopy time was 64 +/- 123 sec. A clear learning curve was evident after the first 80 patients. Contrast use was reduced when compared with a historical control group. Procedural and fluoroscopy times were similar.


CONCLUSIONS
Use of the MNS may enable the successful performance of more complex procedures in the cardiac catheterization laboratory with an improvement in time efficiency.
Kiemeneij
Ferdinand
F
Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, Netherlands. ferdi@euronet.nl
Patterson
Mark S
MS
Amoroso
Giovanni
G
Laarman
GertJan
G
Slagboom
Ton
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000193:education / Q000295:instrumentation* / Q000379:methods; D002983:Clinical Competence; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008280:Magnetics / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012107:Research Design; D015607:Stents; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome; D014584:User-Computer Interface