Coronary Angioplasty for the Total Occlusion Using a New Hydrophilic Guidewire, Crosswire TM

Background and Objectives:Coronary angioplasty of total occlusion is associated with low primary success rate. The most common reason for failure is the inability to cross the lesion with a guidewire. The new nitinol wire consists of an extraordinary flexible nitinol core, a platinum/iridium coil at the distal tip, and a polymer hydrophilic coating providing the wire with an extremely slippery surface after moistening. Methods and Materials:We analyzed the angiographic results in 117 patients (86 M, 31 F, 58.5±11.7 year, who underwent angioplasty for total occlusion with Crosswire TM at Chonnam University Hospital between Oct '97 and Apr '99. Clinical diagnosis was acute myocardial infarction (MI in 61, old MI in 16, unstable angina in 23, and stable angina in 17 patients. Results:Target coronary arteries were 51 left anterior descending arteries (LAD, 13 left circumflex arteries (LCX and 53 right coronary arteries (RCA. Lesion morphology was 40 abrupt and 77 tapered lesions, and collateral circulation was observed in 75 cases. The success rate was 80.3% (94/117. The reasons of procedural failure were failure to cross the lesion using wire in 8 and balloon in 6 cases. In the failed cases, clinical diagnosis was acute MI in 10, unstable angina in 8 and stable angina in 5, and target artery was 11 LAD, 2 LCX and 10 RCA, and collateral circulation was observed in 20. In 56 cases of chronic total occlusion, the success rate was 76.8% (43/56 and the reasons of procedural failure were failure to cross the lesion using wire in 6 and balloon in 2 cases. No major cardiac events were developed. There was no predictive factor for the procedural failure with Crosswire TM for total occlusion. Conclusions:A new nitinol wire, Cro- sswire TM was an effective tool for the recanalization of total occlusive coronary artery. (Korean Circulation J 1999;29(10 :1070-1075