title: Magnetic navigation facilitates percutaneous coronary intervention for complex lesions.
abstract: BACKGROUND
  We sought to determine the utility of a magnetic navigation system (MNS) in treating a variety of coronary artery lesions including those that could not be revascularized with standard percutaneous coronary intervention (PCI). MNS may add value in the treatment of tortuous arteries and bifurcation lesions; however its widespread adoption has lagged because of cost and a lack of clear advantage over conventional PCI. We performed a retrospective analysis to determine whether MNS improved procedural success for highly complex lesions.
  
  
  RESULTS
  One hundred and forty-eight patients underwent treatment with MNS at Mayo Clinic, Rochester. Clinical data, angiographic and procedural characteristics, lesion crossing success and outcomes were reviewed. Overall 133 patients underwent successful revascularization with 87% (143) of 164 lesions crossed using MNS alone. Another six lesions required a combination of MNS and conventional devices resulting in overall success of 91% (149/164). Eighteen complex lesions had previously failed PCI and 12 (67%) were successfully treated with MNS. Success after failed PCI was higher (88%) when a frequent user operated MNS, but occasional users also noted incremental success (30%). Twenty-five chronic total occlusions were included amongst these 164 lesions, with observed antegrade MNS lesion crossing rates of 78% for regular and 14% for occasional users.
  
  
  CONCLUSIONS
  MNS is a useful adjunct to performance of PCI. This specialized technology has a clear learning curve and can facilitate treatment of highly complex lesions.
authors: Division of Cardiovascular Diseases and Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors: Gurpreet S
authors: GS
authors: Sandhu
authors: Saurabh
authors: S
authors: Sanon
authors: David R
authors: DR
authors: Holmes
authors: Rajiv
authors: R
authors: Gulati
authors: Emmanouil S
authors: ES
authors: Brilakis
authors: Ryan J
authors: RJ
authors: Lennon
authors: Charanjit S
authors: CS
authors: Rihal
mesh_terms: D000368:Aged; D002983:Clinical Competence; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D059032:Learning Curve; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome
keywords: chronic total occlusion; complex coronary artery disease; magnetic navigation system; percutaneous coronary intervention; stereotaxis