Vibrational angioplasty and hydrophilic guidewires in the treatment of chronic total coronary occlusions (Journal article)

Michalis, L. K./ Rees, M. R./ Davis, J. A./ Pappa, E. C./ Katsouras, C./ Goudevenos, J./ Sideris, D. A.


PURPOSE: To study the efficacy and safety of vibrational angioplasty versus hydrophilic guidewires for recanalizing chronic total occlusions (CTOs) of the coronary arteries. METHODS: In a retrospective study, 99 patients with old (>3 months) CTOs resistant to conventional techniques were treated either with vibrational angioplasty (group A, n = 72) or 0.014-inch hydrophilic guidewires (group B, n = 27). The selection of the technique (vibrational angioplasty or hydrophylic guidewires) was dependent only upon device availability. A variety of guidewires were employed in conjunction with vibrational angioplasty. RESULTS: The crossing success rates in groups A and B were 86.1% (62/72) and 55.5% (15/27) (p < 0.05), with final procedural success rates of 75% (54/72) and 44.4% (12/27) (p < 0.01), respectively. The main reasons for failure were inability to cross the lesion with a guidewire (10/18 in group A and 12/15 in group B) and large dissections resulting in vessel closure (2/18 in group A and 2/15 in group B). Three major complications were seen, 2 in group A and 1 in group B. Three vessel perforations were reported in group A. Both techniques needed prolonged fluoroscopy times. CONCLUSIONS: Vibrational angioplasty was more successful in treating CTOs compared to hydrophilic guidewires and had similar complication rates (most without clinical sequelae).
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Adult,Aged,Angioplasty/adverse effects/*methods,Chronic Disease,Coronary Angiography,Coronary Disease/radiography/*therapy,Female,Humans,Intraoperative Complications,Male,Middle Aged,Postoperative Complications,Retrospective Studies,Treatment Outcome,Vibration/*therapeutic use
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/17977
ISSN: 1526-6028
Link: http://www.ncbi.nlm.nih.gov/pubmed/10821101
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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