Magnetically navigated percutaneous coronary intervention in distal and/or complex lesions may improve procedural outcome and material consumption.
OBJECTIVE
Comparison of magnetic guidewire navigation in percutaneous coronary intervention (magnetic PCI) across distal and/or complex lesions versus conventional navigation (conventional PCI).


RESULTS
Forty-seven consecutive patients (age 61 +/- 10 yr) undergoing elective single vessel magnetic PCI for distal and/or complex lesions were matched by age and lesion location with 45 patients undergoing conventional PCI (age 63 +/- 10 yr). Technical success rate was defined as an intraluminal wire position distal to the stenosis. Procedural outcome and costs were evaluated. Baseline demographics and angiographic characteristics of the two groups were similar. The technical success rate did not differ between magnetic and conventional PCI (95.7 vs 97.8%; p = 1.00). Significantly shorter procedural and fluoroscopy time were observed for magnetic compared to conventional PCI (29.9 +/- 17.6 vs 41.1 +/- 21 min, p = 0.007; 7.5 +/- 7.3 vs 16.1 +/- 22.4 min, p = 0.02 respectively). Less contrast was used in the magnetic PCI group (58 ml/patient; P = 0.02). These advantages resulted in a mean estimated saving of 1400 euro per patient (P < 0.001). Advantages of procedural outcome were even more pronounced in the ACC/AHA lesion class C subgroup.


CONCLUSIONS
Magnetic compared to conventional PCI is an attractive novel technique that proved to be feasible and safe and might be faster in distal and especially complex lesions.
IJsselmuiden
Alexander J
AJ
Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. ijsselmuiden@vumc.nl
Patterson
Mark S
MS
van Nooijen
Ferdinand C
FC
Tangelder
Geert-Jan
GJ
Dirksen
Maurits T
MT
Amoroso
Giovanni
G
Slagboom
Ton
T
Serruys
Patrick W
PW
Laarman
Gerrit J
GJ
Kiemeneij
Ferdinand
F
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D016022:Case-Control Studies; D003287:Contrast Media / Q000191:economics; D017023:Coronary Angiography / Q000191:economics / Q000295:instrumentation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D017046:Cost Savings; D004867:Equipment Design; D005260:Female; D017048:Health Care Costs; D006801:Humans; D021621:Imaging, Three-Dimensional; D008280:Magnetics / Q000191:economics; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000191:economics / Q000627:therapeutic use; D011857:Radiographic Image Interpretation, Computer-Assisted; D016896:Treatment Outcome; D014584:User-Computer Interface
D003287:Contrast Media; D010975:Platelet Aggregation Inhibitors