TY - JOUR
T1 - Tip Detection–Antegrade Dissection and Re-Entry With New Puncture Wire in CTO Intervention
T2 - Revolution Through 3D-Wiring
AU - Tanaka, Kota
AU - Okamura, Atsunori
AU - Yoshikawa, Ryouhei
AU - Tsuchikane, Etsuo
AU - Ishikawa, Masato
AU - Suzuki, Satoshi
AU - Nagai, Hiroyuki
AU - Sumiyoshi, Akinori
AU - Kawahira, Masatsugu
AU - Yamasaki, Tomohiro
AU - Matsuda, Hiroaki
AU - Iwamoto, Mutsumi
AU - Watanabe, Satoshi
AU - Yamasaki, Keita
AU - Tanaka, Nobuaki
AU - Koyama, Yasushi
AU - Iwanaga, Yoshitaka
AU - Watanabe, Heitaro
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/5
Y1 - 2024/5
N2 - Background: The authors devised the tip detection (TD) method and developed AnteOwl WR intravascular ultrasound to standardize intravascular ultrasound–based 3-dimensional wiring for intraplaque tracking in chronic total occlusion (CTO)–percutaneous coronary intervention (PCI). The TD method also allowed antegrade dissection and re-entry (ADR). Combining TD-ADR with Conquest Pro 12 Sharpened Tip (CP12ST) wire, a new ADR wire with the strongest penetration force developed to date, enabled re-entry anywhere except calcification sites. Objectives: This study investigated the efficacy and feasibility of TD-ADR by comparison of procedural outcomes with Stingray-ADR in CTO-PCI. Methods: Twenty-seven consecutive CTO cases treated by TD-ADR with CP12ST wire between August 2021 and April 2023 and 27 consecutive CTO cases treated by Stingray-ADR with Conquest 8-20 (CP20) wire between March 2018 and July 2021 were retrospectively enrolled as the TD-ADR by CP12ST wire group and Stingray-ADR by CP20 wire group, respectively, from 4 facilities that could share technical information on these procedures. Results: The success rate of the ADR procedure was significantly improved (27 of 27 cases [100%] vs 18 of 27 cases [67%], respectively; P = 0.002) and total procedural time was significantly reduced (median procedural time: 145.0 [Q1-Q3: 118.0-240.0] minutes vs 185.0 [Q1-Q3: 159.5-248.0] minutes, respectively; P = 0.028) in the TD-ADR by CP12ST wire group compared to the Stingray-ADR by CP20 wire group. There were few in-hospital major adverse cardiac and cerebrovascular events or no complications in either group. Conclusions: TD-ADR by CP12ST wire can standardize highly accurate ADR in CTO-PCI.
AB - Background: The authors devised the tip detection (TD) method and developed AnteOwl WR intravascular ultrasound to standardize intravascular ultrasound–based 3-dimensional wiring for intraplaque tracking in chronic total occlusion (CTO)–percutaneous coronary intervention (PCI). The TD method also allowed antegrade dissection and re-entry (ADR). Combining TD-ADR with Conquest Pro 12 Sharpened Tip (CP12ST) wire, a new ADR wire with the strongest penetration force developed to date, enabled re-entry anywhere except calcification sites. Objectives: This study investigated the efficacy and feasibility of TD-ADR by comparison of procedural outcomes with Stingray-ADR in CTO-PCI. Methods: Twenty-seven consecutive CTO cases treated by TD-ADR with CP12ST wire between August 2021 and April 2023 and 27 consecutive CTO cases treated by Stingray-ADR with Conquest 8-20 (CP20) wire between March 2018 and July 2021 were retrospectively enrolled as the TD-ADR by CP12ST wire group and Stingray-ADR by CP20 wire group, respectively, from 4 facilities that could share technical information on these procedures. Results: The success rate of the ADR procedure was significantly improved (27 of 27 cases [100%] vs 18 of 27 cases [67%], respectively; P = 0.002) and total procedural time was significantly reduced (median procedural time: 145.0 [Q1-Q3: 118.0-240.0] minutes vs 185.0 [Q1-Q3: 159.5-248.0] minutes, respectively; P = 0.028) in the TD-ADR by CP12ST wire group compared to the Stingray-ADR by CP20 wire group. There were few in-hospital major adverse cardiac and cerebrovascular events or no complications in either group. Conclusions: TD-ADR by CP12ST wire can standardize highly accurate ADR in CTO-PCI.
KW - IVUS-based 3D wiring
KW - antegrade dissection re-entry
KW - chronic total occlusion
KW - coronary intervention
KW - tip detection method
UR - http://www.scopus.com/inward/record.url?scp=85187646066&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85187646066&partnerID=8YFLogxK
U2 - 10.1016/j.jacasi.2023.11.017
DO - 10.1016/j.jacasi.2023.11.017
M3 - Article
AN - SCOPUS:85187646066
SN - 2772-3747
VL - 4
SP - 359
EP - 372
JO - JACC: Asia
JF - JACC: Asia
IS - 5
ER -