title: Structural Damage of Jailed Guidewire During the Treatment of Coronary Bifurcation Lesions: A Microscopic Randomized Trial.
abstract: The study sought to compare the safety (resistance to damage) and efficacy (ability to cross the side branch) of polymer-coated and non-polymer-coated guidewires in the jailed wire technique used during the percutaneous treatment of bifurcation lesions.
  
  
  
  The jailed wire technique is a useful strategy in the treatment of bifurcation lesions by provisional stenting. However, these wires can be damaged or even be broken during their removal.
  
  
  
  We performed a randomized study in patients with bifurcation lesions treated by provisional stenting. The jailed wire technique was mandatory, and the types of guidewires, polymer-coated (n = 115) and non-polymer-coated (n = 120), were randomized. After the procedures, the wires were evaluated by stereoscopic microscopy. The induced damage in the wires was classified as follows: no damage, mild, moderate, or severe.
  
  
  
  The clinical characteristics were similar between patients treated with polymer-coated or non-polymer-coated wires. Polymer-coated wires were significantly (p < 0.001) more resistant to retrieval damage (only 2 wires showed mild damage) than were non-polymer-coated wires. However, 63 (55%) of the non-polymer-coated wires were damaged; 37 (32%), 24 (21%), and 2 (2%) had mild, moderate, and severe damage, respectively. Additionally, the jailed length of the wire was a factor contributing to the degree of wire damage. The time of side branch wiring was shorter in the polymer-coated wire group (19 ± 40 s vs. 42 ± 72 s; p < 0.05).
  
  
  
  Jailed wires during interventional procedures of bifurcation lesions commonly showed microscopic damage. Polymer-coated wires were more resistant to retrieval damage and were more efficient in crossing the side branch ostium than non-polymer-coated wires. (Jailed Wire Technique in the Treatment of Coronary Bifurcations Lesions With Stent: Stereoscopic Microscopy Study; NCT02516891).
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain. Electronic address: manuelpanalvarez@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Villanueva
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Chavarria
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Suarez de Lezo
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Segura
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Carrasco
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Hidalgo
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Lopez Aguilera
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Rodriguez
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Puente
authors.affiliation: Department of Cardiology, Reina Sofia Hospital, University of Córdoba (IMIBIC), Cordoba, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Suarez de Lezo
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011108:Polymers / Q000737:chemistry*; D011446:Prospective Studies; D016037:Single-Blind Method; D013030:Spain; D015607:Stents; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D011108:Polymers
keywords: bifurcation lesions; jailed wire technique; provisional stenting