Recanalization of chronic coronary occlusions using a new hydrophilic guidewire.

Chronic total occlusion remains a relative contraindication and the main cause of failure of coronary angioplasty. Previously available hydrophilic guidewires had numerous limitations. The Crosswire is a new 0.014" hydrophilic nitinol guidewire which can be accommodated by very-low-profile balloon catheters and has a shapeable and highly radiopaque platinum-iridium coiled tip. This guidewire was used in 55 patients with 56 chronic coronary occlusions in which recanalization by conventional guidewires had failed. Clinical success was 79%. Coronary perforation occurred in two cases, one of them requiring pericardiocentesis for tamponade. These results illustrate the usefulness of this new guidewire in the treatment of chronic total occlusions.