BACKGROUND:We examined guidewire and microcatheter utilization during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS:We examined device utilization in 2,968 CTO PCIs performed in 2,936 patients at 19 US and two international center between January 2016 and January 2019. RESULTS:The median number of antegrade guidewires used per case declined (5 in 2016 vs 3 in 2019) and was higher in higher complexity lesions (2 in J-CTO 0 vs. 8 in J-CTO 4 or 5 score). In antegrade-only procedures, the most frequently used guidewires were the Pilot 200 (Abbott Vascular, 37%), Fielder XT (Asahi Intecc, 25%) and Gaia third (Asahi Intecc, 18%), while the most commonly used microcatheters were the Turnpike Spiral (Vascular Solutions, 18%) and Turnpike (Vascular Solutions, 16%). Compared with 2012-2015, during 2016-2019 use of novel equipment such as the Gaia guidewires and the Turnpike microcatheters led to decreased use of Confianza Pro 12 (Asahi Intecc) wire and Corsair (Asahi Intecc) family of microcatheters. In retrograde cases, the guidewires most commonly used were the Sion (44%), Pilot 200 (27%) and Fielder FC (26%), while the Corsair/Corsair Pro, Turnpike LP (Vascular Solutions) and Caravel (Asahi Intecc) were the most frequently used microcatheters for collateral crossing (29%, 26% and 22%, respectively). CONCLUSIONS:The most commonly used guidewires during CTO PCI are polymer-jacketed guidewires and the most commonly used microcatheters are torquable microcatheters.

译文

摘要背景:我们研究了慢性完全阻塞(CTO)经皮冠状动脉介入治疗(PCI)期间导丝和微导管的利用率。
方法:我们研究了2016年1月至2019年1月之间在美国19个州和两个国际中心的2936名患者中执行的2968个CTO PCI中的设备利用率。
结果:每例使用的顺行导丝的中位数减少了(2016年为5例,2019年为3例),而在复杂程度更高的病变中则更高(J-CTO 0为2分,J-CTO 4或5分为8分)。在仅顺行手术中,最常用的导丝是Pilot 200(Abbott Vascular,37%),Fielder XT(Asahi Intecc,25%)和Gaia第三(Asahi Intecc,18%),而最常用的微导管是Turnpike螺旋形(血管解决方案,占18%)和Turnpike螺旋形(血管解决方案,占16%)。与2012-2015年相比,在2016-2019年期间,使用Gaia导丝和Turnpike微导管等新型设备导致减少了Confianza Pro 12(Asahi Intecc)线和Corsair(Asahi Intecc)系列微导管的使用。在逆行情况下,最常用的导丝是Sion(44%),Pilot 200(27%)和Fielder FC(26%),而Corsair / Corsair Pro,Turnpike LP(Vascular Solutions)和Caravel(Asahi Intecc)是最常用于侧支穿刺的微导管(分别为29%,26%和22%)。
结论:CTO PCI期间最常用的导丝是带有护套的导丝,最常用的微导管是可弯曲的微导管。

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