Objective: To evaluate the potential benefits of placing intra-aortic vacant guide wire on interventional treatment of aorto-ostial lesions.

Methods: A total of 86 consecutive patients underwent percutaneous coronary interventions (PCI) for aorto-ostial lesions were randomly divided into conventional treatment group (group A) and intra-aortic vacant guide wire group (group B). Standard PCI techniques were applied in group A and an intra-aortic vacant guide wire was placed outside the guiding catheter before the guiding catheter into the target coronary artery in group B on basis of standard PCI techniques. The number of guiding catheter, guide wire, X-ray exposure time, total PCI time, the incidence of pressure drop and malignant arrhythmia, contrast agent dose and the number of failure cases were compared between the two groups.

Results: The number of used guide wire was similar between the groups (2.0 ± 1.1 vs. 2.2 ± 0.4, P > 0.05) and the number of guiding catheter used was significantly more in group A than in group B (2.3 ± 1.1 vs. 1.3 ± 0.5, P < 0.01). The X-ray exposure time (18.8 min ± 6.9 min vs. 14.2 min ± 5.7 min, P < 0.01) was significantly less in groups B and the total PCI time (31.2 min ± 8.1 min vs. 20.1 min ± 4.5 min, P < 0.01) and the amount of contrast agent (193.5 ml ± 25.4 ml vs. 130.6 ml ± 32.8 ml, P < 0.01) and the frequency of pressure drop (19 cases vs. 2 cases, P < 0.01) were all significantly higher in group A than in group B. Incidence of malignant ventricular arrhythmia (8 vs. 0) and procedure failure (6 vs. 0) was also higher in group A compared to group B.

Conclusion: The method of using Intra-aortic vacant guide wire is associated with reduced risk and improved success rate of PCI for aorto-ostial lesions.

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