title: Feasibility and safety of guidewire navigation using a magnetic navigation system in coronary artery stenoses.
abstract: OBJECTIVE
  Few studies are available on magnetic navigation system (MNS) for coronary artery disease. The present investigation was conducted to evaluate the feasibility and safety of guidewire navigation with a MNS in diseased coronary arteries.
  
  
  RESULTS
  Between February 2004 and August 2005, a total of 59 patients (68 target vessels) underwent magnetic-assisted guidewire navigation in coronary arteries with stenoses amenable to coronary intervention. Patients were excluded if any of the following conditions applied: pacemakers or cardioverter defibrillator implanted; acute myocardial infarction; thrombotic lesions; chronic total occlusion; claustrophobia; and renal dysfunction with serum creatinine > 2.5mg/dl. Procedural success was defined as successful guidewire passage distal to the stenoses with no procedural events, defined as either perforation or dissection. Magnetic guidewires successfully crossed 60 (88%) lesions. Only 1 patient experienced a minor dissection of vessel wall in a circumflex lesion and was treated with a coronary stent. There was no other complication related to the magnetic guidewire. Nineteen (27.3%) coronary interventions were performed with magnetic guidewires. In 4 complex lesions (a lesion located in saphenous vein graft with proximal severe tortuosity; 3 approaches to stent-jailed side branch), where conventional wires failed to cross the culprit lesions, magnetic navigation achieved successful guidewire passage.
  
  
  CONCLUSIONS
  Guidewire navigation using a MNS was feasible and safe. In the four complex cases, magnetic navigation enabled crossing of lesions in which conventional attempts failed. Further studies are needed to better evaluate the efficacy of MNS compared with conventional manual navigation.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tsuchida
authors.forename: Héctor M
authors.initials: HM
authors.lastname: García-García
authors.forename: Shuzou
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Andrew T L
authors.initials: AT
authors.lastname: Ong
authors.forename: Ruchir
authors.initials: R
authors.lastname: Sehra
authors.forename: Martin
authors.initials: M
authors.lastname: van der Ent
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.forename: Willem J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys