Preference and success rate of 0.014 inch guidewires in the coronary chronic total occlusion interventions

Procedures for the chronic total occlusion (CTO) is a still clinical challenge with relatively lower success rate. Recent advance in the biotechnology and introduction of CTO dedicated guidewires increased the procedural success rate of CTO interventions. Herein, we aimed to reveal the preference and success rate of 0.014 inch (0.36 mm) coronary guidewires in the CTO interventions. A total of 177 patients with indication of coronary CTO procedure were included to study. Use of 1-3 guidewires and crossing of the CTO lesion with initial choice guidewires was defined as rational guidewires usage. The CTO lesions was classified according to J CTO score and Eurocto score for evaluating the difficulty of the procedures. Then statistical analysis was performed to assess the guidewire choise, crossability and contributors of rational guidewire usage. The mean J-CTO score was 1.42±1.16 and the mean Eurocto score was 1.44±1.18. Success rate of the procedures was 90,4%. Initial choice guidewires was crossed the lesion in the 44,1 % of the cases in which 1-3 guidewires was used (82,1%). Crossability of polymeric and moderate tip stiff guidewires are higher (82,1% and 64,1%) and Pilot series was the most successfull brand (36,2%). Logistic regression analysis confirmed that J-CTO score, procedural technique, guidewire type and the tip stiffness was the major predictors of rational guidewire usage. Our analysis showed that, use of polymeric and moderate tip stiff guidewires, particulary Pilot brand, is associated with economical and rational guidewire usage in the easy and intermediate difficulty CTO cases