title: Guidewires used in first intentional single wiring strategy for chronic total occlusions of the left anterior descending coronary artery.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the left anterior descending (LAD) specifically is associated with improved long-term 5 year survival as compared to PCI failure. The procedure is associated with usage of different types of dedicated guidewires by simple or complex techniques aiming to reopen the occluded artery.
  
  
  OBJECTIVE
  To describe types and outcome of guidewires used in LAD-CTO utilizing a first intentional single wiring simple strategy.
  
  
  METHODS
  A single center prospective registry for all consecutive patients with a PCI attempt to a native LAD CTO. The initial strategy for lesion crossing was Single wiring.
  
  
  RESULTS
  A total of 30 patients with LAD CTO lesions (100%), were recorded. Mean age was 71.6 + 15 years, 77% were Males, risk factors Hypertension in 63%, Diabetes 27%, Dyslipidemia 57%, smoking 40%, hereditary in 13% of patients. Isolated guidewire (GW) success rate was very high 93%. Single wiring was the prevailing technique used in 97% of successfull lesions (83% of total cases) while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% with a GW success rate of 67%. Successful Crossing GW types in our patients were 44% Soft Tapered GWs; fielder XT (44%), 36% were Soft Non Tapered Pilot 50 (28%), whisper (8%), while 16% were Stiff Non tapered GWs; Miracle 12 (8%), Miracle 6 (4%), Miracle 3 (4%), and 4% were Stiff Tapered GWs; Progress 200 (4%).
  
  
  CONCLUSIONS
  Single wiring as an initial strategy in PCI for LAD-CTO lesions has a high success rate and is associated with a 44% majority of Soft Tapered GWs, 36% Soft Non Tapered, 16% Stiff Non tapered GWs, and 4% Stiff Tapered GWs.
authors: Department of Critical Care, Cairo University, Giza, Egypt.
authors: Yasser S
authors: YS
authors: Nassar
authors: Nicolas
authors: N
authors: Boudou
authors: Nicolas
authors: N
authors: Dumonteil
authors: Thibault
authors: T
authors: Lhermusier
authors: Didier
authors: D
authors: Carrie
keywords: Chronic total occlusion; first intention; guidewires; left anterior descending; single wiring
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