Comparison of magnetically navigated and conventional wire percutaneous coronary intervention of a single discrete stenosis.
OBJECTIVE
The objective of this study is to compare magnetic guidewire navigation in percutaneous coronary intervention (MPCI) to conventional percutaneous coronary intervention (CPCI) for the elective treatment of a single discrete stenosis.


BACKGROUND
Magnetic navigation actively steers an angioplasty wire-tip and may improve PCI procedures, but it is not known whether the intricacy and increased preparation necessary for using the system negatively influences the performance of simple procedures in terms of time and contrast use.


METHODS
The procedures of 44 patients (mean age 65 +/- 10 year) undergoing elective single vessel MPCI of a single discrete stenosis were matched for age, gender, and lesion location with 44 concurrent patients (mean age 65 +/- 10 year) undergoing CPCI. The major endpoint was procedural time.


RESULTS
Technical success was defined as an intraluminal wire position distal to the stenosis. Procedural outcome, contrast use, and costs were evaluated. Clinical demographics and angiographic characteristics of the two groups were similar, except for a higher incidence of previous MI and class III angina pectoris in the conventional group. The technical success rate was high and identical in both groups (97.7%). Procedural and fluoroscopy times were not significantly different for MPCI compared to CPCI (21.0 +/- 14.5 min vs. 24.7 +/- 14.0 min; 4.9 +/- 4.8 min vs. 7.3 +/- 10.3 min, P = NS). There was a significant reduction in median contrast use [60 ml/patient (41-100) vs. 100 ml/patient (64-130); P = 0.006].


CONCLUSIONS
Magnetic navigation does not increase procedural time, irradiation, equipment use, or cost compared to conventional PCI of a single discrete stenosis. It proved feasible, yielding high rates of procedural success with less contrast use.
Patterson
Mark S
MS
Amsterdam Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. markspatterson@doctors.net.uk
van Nooijen
Ferdinand
F
Ijsselmuiden
Alexander
A
Dirksen
Maurits
M
Van Domburg
Ron
R
Serruys
Patrick
P
Kiemeneij
Ferdinand
F
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D003287:Contrast Media; D017023:Coronary Angiography / Q000009:adverse effects / Q000191:economics; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000191:economics / Q000628:therapy*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008280:Magnetics / Q000191:economics / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000009:adverse effects / Q000191:economics; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D003287:Contrast Media