title: Initial experience with a magnetic navigation system for invasive treatment in patients with non-ST-segment elevation acute coronary syndromes.
abstract: BACKGROUND
  Magnetic navigation system (MNS) assisted percutaneous coronary intervention (MPCI) has been demonstrated an advantage over conventional PCI (CPCI) in complex lesions and tortuous vessels. However, the benefits of MNS in clinical unstable and vulnerable lesions were little studied. The aim of this study is to evaluate the feasibility and benefits of MPCI versus CPCI in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS).
  
  
  METHODS
  Thirty-seven consecutive patients with NSTE-ACS undergoing MPCI were compared with 37 matched CPCI patients selected from the same concurrent database. Time to cross lesion, fluoroscopy time, and contrast usage to cross lesion were used as primary end-points.
  
  
  RESULTS
  Of the 37 culprit lesions in MPCI, 36 were crossed successfully giving a success rate of 97.3%. The procedure and the fluoroscopy time to cross the lesion were similar between the magnetic and conventional PCI groups (82.0 ± 67.9 seconds vs. 85.8 ± 59.2 seconds, P = 0.692, and 62.6 ± 57.6 seconds vs. 65.4 ± 49.5 seconds, P = 0.738, respectively). In Type A/B1 lesions, there seemed no difference in contrast use (2.7 ± 0.7 mL vs. 3.3 ± 0.9 mL, P = 0.284). But as lesion complexity increased from type B2 to C, significantly less contrast was needed in type B2 (5.1 ± 2.6 mL vs. 7.9 ± 4.0 mL, P = 0.019) and type C (9.8 ± 5.7 mL vs. 14.7 ± 7.4 mL, P = 0.030). No major adverse cardiac events were observed in either the MPCI or CPCI group.
  
  
  CONCLUSIONS
  MNS assisted technique appears to be feasible and effective in NSTE-ACS patients with more complex lesions; however, it probably offers little benefit in simple lesions like ACC/AHA type A/B1.
authors: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China. wangnuo@263.net
authors: Hui
authors: H
authors: Wang
authors: Chunjian
authors: C
authors: Li
authors: Liansheng
authors: L
authors: Wang
authors: Zhijian
authors: Z
authors: Yang
authors: Kejiang
authors: K
authors: Cao
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008280:Magnetics / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D013997:Time Factors