title: Structural Damage to Jailed Guidewire During the Treatment of Coronary Bifurcations: Microscopic Evaluation.
abstract: OBJECTIVE
  The use of the jailed guidewire technique is highly useful when treating bifurcation lesions by provisional stenting. However, at the time of withdrawal, the guidewire can suffer damage and even fracture. The aim of this study was to evaluate structural damage in both polymer-coated and nonpolymer-coated jailed guidewires.
  
  
  METHODS
  Between January 2011 and December 2012, an observational study was conducted using stereoscopic microscopy to evaluate 135 jailed guidewires (45 nonpolymer-coated and 90 polymer-coated) previously used in the percutaneous treatment of bifurcation lesions. Damage after withdrawal was classified as mild, moderate, or severe.
  
  
  RESULTS
  Age and sex distributions were similar in both groups of patients treated with polymer-coated and nonpolymer-coated guidewires. However, operators selected polymer-coated guidewires more frequently when treating more complex bifurcations and in diabetic patients. Some type of microscopic damage was observed in 25 of the guidewires analyzed (18%). Paradoxically, damage was more common in nonpolymer-coated guidewires (53.0% vs 1.1%; P<.001). None of the guidewires suffered complete fracture.
  
  
  CONCLUSIONS
  Coronary guidewires that are jailed during the treatment of bifurcations using provisional stenting often suffer nonsevere microscopic damage. Although polymer-coated guidewires were used in more complex bifurcation lesions, paradoxically, they were damaged less frequently.
authors.affiliation: Área de Cardiología, Hospital Santa Bárbara, Puertollano, Ciudad Real, Spain. Electronic address: Lnavf@hotmail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Villanueva
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Suárez de Lezo
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.affiliation: Servicio de Cardiología, Hospital Dr. Negrín, Universidad de Las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Martín
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Segura
authors.affiliation: Servicio de Cardiología, Hospital Dr. Negrín, Universidad de Las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Medina
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D010865:Pilot Projects; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015607:Stents
keywords: Angioplastia coronaria; Bifurcation lesions; Coronary angioplasty; Jailed guidewire technique; Lesiones de bifurcación; Técnica de la guía encarcelada