TY - JOUR
T1 - Laser wire for crossing chronic total occlusions
T2 - 'Learning phase' results from the U.S. TOTAL trial
AU - Oesterle, Stephen N.
AU - Bittl, John A.
AU - Leon, Martin B.
AU - Hamburger, Jaap
AU - Tcheng, James E.
AU - Litvack, Frank
AU - Margolis, James
AU - Gilmore, Paul
AU - Madsen, Ronald
AU - Holmes, David
AU - Moses, Jeffrey
AU - Cohen, Howard
AU - King, Spencer
AU - Brinker, Jeffrey
AU - Hale, Terence
AU - Geraci, Dean J.
AU - Kerker, William J.
AU - Popma, Jeffrey
PY - 1998/6
Y1 - 1998/6
N2 - The Prima laser guidewire system (Spectranectics Corp., Colorado Springs, CO) consists of an 0.018'' hypotube containing a bundle of 45-μm optical fibers coupled to a pulsed excimer laser operating at a tip fluence of 60 ml/mm2 and a repetition rate ranging from 25-40 Hz. This laser guidewire was specifically designed to cross total occlusions refractory to passage with conventional wires. The Prima wire was evaluated in a feasibility study at 15 U.S. centers. Following failure to cross s total occlusion with approved guidewires, the Prima wire was utilized in 179 patients. Average age of subjects was 61 yr. Lesion locations included left anterior descending (36%), right (45%), and circumflex (19%) coronary arteries. Mean angiographic age of total occlusions was 70 wk (range, 2- 1,020 wk, median, 14 wk). The use of the Prima wire either solely or in combination with conventional guidewires resulted in successful crossing in 61% of these previously impenetrable occlusions. Failure of the device was commonly related to length of the occlusion and tortuosity along the occluded pathway. Major complications included myocardial infarction in 7 patients (3.9%), tamponade in 3 (1.7%), and death in 2 (1.1%). This 'learning phase' pilot study confirmed the feasibility of a laser guidewire in chronic total occlusions that are resistant to passage of conventional guidewires. An extended registry at these investigative sites is planned.
AB - The Prima laser guidewire system (Spectranectics Corp., Colorado Springs, CO) consists of an 0.018'' hypotube containing a bundle of 45-μm optical fibers coupled to a pulsed excimer laser operating at a tip fluence of 60 ml/mm2 and a repetition rate ranging from 25-40 Hz. This laser guidewire was specifically designed to cross total occlusions refractory to passage with conventional wires. The Prima wire was evaluated in a feasibility study at 15 U.S. centers. Following failure to cross s total occlusion with approved guidewires, the Prima wire was utilized in 179 patients. Average age of subjects was 61 yr. Lesion locations included left anterior descending (36%), right (45%), and circumflex (19%) coronary arteries. Mean angiographic age of total occlusions was 70 wk (range, 2- 1,020 wk, median, 14 wk). The use of the Prima wire either solely or in combination with conventional guidewires resulted in successful crossing in 61% of these previously impenetrable occlusions. Failure of the device was commonly related to length of the occlusion and tortuosity along the occluded pathway. Major complications included myocardial infarction in 7 patients (3.9%), tamponade in 3 (1.7%), and death in 2 (1.1%). This 'learning phase' pilot study confirmed the feasibility of a laser guidewire in chronic total occlusions that are resistant to passage of conventional guidewires. An extended registry at these investigative sites is planned.
KW - Angioplasty
KW - Chronic total occlusion
KW - Guidewire
KW - Laser
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UR - http://www.scopus.com/inward/citedby.url?scp=0031804263&partnerID=8YFLogxK
U2 - 10.1002/(SICI)1097-0304(199806)44:2<235::AID-CCD23>3.0.CO;2-K
DO - 10.1002/(SICI)1097-0304(199806)44:2<235::AID-CCD23>3.0.CO;2-K
M3 - Article
C2 - 9637452
AN - SCOPUS:0031804263
SN - 0098-6569
VL - 44
SP - 235
EP - 243
JO - Catheterization and cardiovascular diagnosis
JF - Catheterization and cardiovascular diagnosis
IS - 2
ER -