title: Safety of hydrophilic guidewires used for side-branch protection during stenting and proximal optimization technique in coronary bifurcation lesions.
abstract: OBJECTIVE
  In coronary bifurcation lesions (CBL), hydrophilic guidewires used for side-branch (SB) protection can be withdrawn from underneath the stent easier than other wires. However, the safety of which has not been investigated.
  
  
  METHODS
  We performed scanning electron microscopic (SEM) examination of hydrophilic wires - the Whisper and Runthrough wires - used for SB protection during stenting and proximal optimization technique (POT) in 30 patients with CBL. The distal 15cm of the wire was examined every 1mm by SEM and 4500 segments were analyzed to investigate for wire fracture, polymer shearing (PS), and its correlations with post-stenting creatine kinase (CK)-MB release.
  
  
  RESULTS
  SEM examination showed no evidence for wire fracture. The total area of PS and the largest defect on the wire were significantly larger with the Whisper wire versus the Runthrough wire (0.15±0.04mm2vs. 0.026±0.01mm2and 0.04±0.05mm2vs. 0.01±0.01mm2; P<0.05, respectively). The total length of PS and the longest defect on the wire were significantly longer with the Whisper wire vs. the Runthrough wire (12.1±14.5mm vs. 2.7±3.0mm and 2.9±4.2mm vs. 1.0±1.2mm; P<0.05, respectively), but there were weak correlations between the extents of PS with CK-MB release.
  
  
  CONCLUSIONS
  Hydrophilic guidewires may be safely used for SB protection during stenting and POT in CBLs. The extent of PS was significantly greater with the Whisper wire than with the Runthrough wire, but its correlation with post-stenting CK-MB release was weak.
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Arka
authors.initials: A
authors.lastname: Chatterjee
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA; Department of Biomedical Engineering, University of Alabama-Birmingham, USA.
authors.forename: Brigitta C
authors.initials: BC
authors.lastname: Brott
authors.affiliation: Department of Material Science and Engineering, University of Alabama-Birmingham, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Foley
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Oluseun
authors.initials: O
authors.lastname: Alli
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Sasse
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Firas
authors.initials: F
authors.lastname: Al Solaiman
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Gautam
authors.initials: G
authors.lastname: Reddy
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Ather
authors.affiliation: Division of Cardiology, University of Alabama-Birmingham, USA. Electronic address: mleesar@uab.edu.
authors.forename: Massoud A
authors.initials: MA
authors.lastname: Leesar
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D062906:Cardiac Catheters; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D052279:Creatine Kinase, MB Form / Q000097:blood; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011108:Polymers / Q000737:chemistry*; D015607:Stents; D013499:Surface Properties; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D011108:Polymers; D052279:Creatine Kinase, MB Form
keywords: Coronary bifurcation lesions; Hydrophilic guidewire; Polymer shearing; Proximal optimization