Magnetic navigation in a coronary phantom: experimental results.
OBJECTIVE
The objective was to investigate the efficacy of a magnetic navigation system (MNS) in a coronary phantom.


BACKGROUND
The number of coronary interventional procedures performed is steadily increasing with the availability of new devices to treat more complex lesions. Vessel tortuosity remains an important limiting factor in percutaneous coronary intervention.


METHODS
The MNS can orient the tip of magnetized wire. The coronary phantom is a representation of the coronary tree. Two operators using both a magnetic wire and a standard wire, measured the procedural time (PT), the fluoroscopic time (FT) and the radiation exposure/area product (DAP) required to navigate through to fourteen segments. Ten wire advancements were performed per segment.


RESULTS
In all but two segments, the PT was significantly longer using magnetic navigation than using manual navigation. The median FT in the left main artery (LMA) - first septal segment was 7 seconds vs. 18 seconds, with magnetic and manual navigation respectively, (p=0.05); in the LMA - obtuse marginal segment the median FT was 15 seconds with magnetic navigation vs. 29.5 seconds with manual navigation, (p=0.01); in the segment from proximal right coronary artery (RCA1) to the acute marginal branch, the median FT was 8 seconds with magnetic vs. 11 seconds with manual navigation, (p=0.05); and in the RCA1 -posterior descending segment the median FT was 9.5 seconds with magnetic vs. 15 seconds with manual navigation, (p=0.006).


CONCLUSIONS
The MNS facilitates wire access to distal segments in a coronary phantom, with a reduction in FT and radiation exposure using magnetic navigation in tortuous segments.
García-García
Héctor M
HM
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Tsuchida
Keiichi
K
Meulenbrug
Hans
H
Ong
Andrew T L
AT
Van der Giessen
Willem J
WJ
Serruys
Patrick W
PW