title: Magnetic navigation system and CT roadmap-assisted percutaneous coronary intervention: a comparison to the conventional approach.
abstract: BACKGROUND
  Computed tomography coronary angiography (CTCA) has been successfully integrated with the magnetic navigation system (MNS) to facilitate a roadmap-assisted percutaneous coronary intervention (PCI). The aim of this study was to compare this new approach of PCI versus conventional PCI regarding the difference of contrast usage, x-ray exposure, procedure success, and in-hospital expenses.
  
  
  METHODS
  Thirty-eight patients with stable coronary artery disease and coronary artery lesions of ≥70% diameter stenosis diagnosed by both pre-procedure CTCA and coronary angiography (CAG) were enrolled to receive the MNS and CT roadmap-assisted PCI. Another 38 patients were consecutively recruited to receive conventional PCI, matched with the MNS group by the vessel and lesion type base on American College of Cardiology/American Heart Association criteria.
  
  
  RESULTS
  Regarding the process of the guidewire placement, wherein the technical difference of the two procedures exists, the median contrast usage for guidewire crossing was significantly lower in the MNS group than in the conventional group [0.0 mL (interquartile range [IQR], 0.0-3.0 mL) vs 5.0 mL (IQR, 3.1-6.8 mL); P<.001], with zero contrast usage in 25 of the 44 guidewire placements in the MNS group, but in none of the conventional group; the radiation dosage for guidewire crossing in the MNS group was also significantly lower than in the conventional group (235.8 μGym² [IQR, 134.9-455.1 μGym²] vs 364.4 μGym² [IQR, 223.4-547.2 μGym²]; P=.033). There were no significant differences between the two groups concerning the total contrast usage, total radiation dosage of the PCI, the procedural fees, or the overall in-hospital expenses. All of the enrolled vessels were successfully intervened in both groups.
  
  
  CONCLUSIONS
  In PCI of simple lesions, the application of CT guidance and magnetic navigation had modest impacts on radiation dosage and contrast usage for wire crossing, but no impact on overall radiation dosage or contrast usage for the procedure. In addition, the use of CT roadmap and MNS was likely more expensive compared to PCI using conventional radiographic technique.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, 300, Guangzhou Road, Nanjing, Jiangsu Province 210029, China.
authors.forename: Ruina
authors.initials: R
authors.lastname: Hao
authors.forename: Qiu
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zhuowen
authors.initials: Z
authors.lastname: Xu
authors.forename: Lijun
authors.initials: L
authors.lastname: Tang
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Yang
authors.forename: Kejiang
authors.initials: K
authors.lastname: Cao
authors.forename: Chunjian
authors.initials: C
authors.lastname: Li
mesh_terms: D000368:Aged; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000191:economics / Q000628:therapy*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008280:Magnetics / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000191:economics / Q000379:methods*; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media