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| http://dx.doi.org/10.1093/ehjcr/ytac476 | DOI Listing |
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Randomized comparison of a Gladius first versus standard antegrade wiring strategy for crossing coronary chronic total occlusions: the Gladius first trial.
J Invasive Cardiol
December 2024
Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland.
Objectives: Antegrade wiring (AW) is the most common coronary chronic total occlusion (CTO) crossing strategy and usually relies upon stepwise guidewire escalation starting from the low tip-load polymer-jacketed wire (standard guidewire escalation). The authors aimed to investigate whether the upfront use of intermediate tip-load polymer-jacketed guidewire translates into improved procedural outcomes of CTO percutaneous coronary intervention (PCI).
Methods: The Gladius First trial was a single-center, investigator-initiated, randomized, prospective trial.
Knuckle Guidewires to Create Dissections in Chronic Total Occlusion Percutaneous Coronary Intervention: Position Statement.
JACC Cardiovasc Interv
October 2024
Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
Dissection and re-entry techniques are essential to achieve safe and effective chronic total occlusion recanalization. Several studies have demonstrated similar outcomes following extraplaque stenting compared with intraplaque stenting. Dissection techniques most often involve the use of knuckled wires to progress within and beyond the chronic total occlusion segment.
View Article and Find Full Text PDFPercutaneous Retrieval of a Peeled-off Fragment of a Hydrophilic Wire after a Cuffed Tunneled Hemodialysis Catheter Placement: A Case Report.
Acta Cardiol Sin
May 2024
Department of Surgery.
Safe and predictable transcatheter removal of broken coronary guidewires: the 'knuckle-twister' technique: a case series report.
Eur Heart J Case Rep
August 2023
Department of Cardiology, Medizinische Universitätsklinik, Kantonsspital Baselland, Rheinstrasse 26, Liestal 4410, Switzerland.
Background: Guidewire fracture and loss is a rare but well-known and feared complication of percutaneous coronary interventions. With the increasing number of complex coronary interventions and procedures for chronic total occlusions, operators face new challenges and boundaries, and the need for solutions to otherwise rare complications is increasing.
Case Summary: We have developed a simple and practical method for retrieving fractured and lost guidewires, called the 'knuckle-twister' technique.
Intravascular ultrasound-guided dissection recanalization in a patient with ST-segment elevation myocardial infarction: a case report.
Eur Heart J Case Rep
April 2023
Division of Cardiovascular Medicine, Hakujikai Memorial General Hospital, 5-11-1 Shikahama, Adachi-ku, Tokyo 123-0864, Tokyo, Japan.
Background: In primary percutaneous coronary intervention (PCI) for acute myocardial infarction, we occasionally experience challenging cases where conventional guidewires cannot pass through the lesion. In such cases, if the use of a tapered guidewire or polymer jacket guidewire is also unsuccessful, coronary artery bypass surgery becomes inevitable. Therefore, other methods to enable revascularization in a reliable and timely manner are desirable.
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