Magnetic navigation facilitates percutaneous coronary intervention for complex lesions

Gurpreet S Sandhu, Saurabh Sanon, David Holmes, Rajiv Gulati, Emmanouil S. Brilakis, Ryan J. Lennon, Charanjit Rihal

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background We sought to determine the utility of a magnetic navigation system (MNS) in treating a variety of coronary artery lesions including those that could not be revascularized with standard percutaneous coronary intervention (PCI). MNS may add value in the treatment of tortuous arteries and bifurcation lesions; however its widespread adoption has lagged because of cost and a lack of clear advantage over conventional PCI. We performed a retrospective analysis to determine whether MNS improved procedural success for highly complex lesions. Methods and Results One hundred and forty-eight patients underwent treatment with MNS at Mayo Clinic, Rochester. Clinical data, angiographic and procedural characteristics, lesion crossing success and outcomes were reviewed. Overall 133 patients underwent successful revascularization with 87% (143) of 164 lesions crossed using MNS alone. Another six lesions required a combination of MNS and conventional devices resulting in overall success of 91% (149/164). Eighteen complex lesions had previously failed PCI and 12 (67%) were successfully treated with MNS. Success after failed PCI was higher (88%) when a frequent user operated MNS, but occasional users also noted incremental success (30%). Twenty-five chronic total occlusions were included amongst these 164 lesions, with observed antegrade MNS lesion crossing rates of 78% for regular and 14% for occasional users. Conclusions MNS is a useful adjunct to performance of PCI. This specialized technology has a clear learning curve and can facilitate treatment of highly complex lesions.

Original languageEnglish (US)
Pages (from-to)660-667
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume84
Issue number4
DOIs
StatePublished - Oct 1 2014

Fingerprint

Percutaneous Coronary Intervention
Learning Curve
Coronary Vessels
Therapeutics
Arteries
Technology
Costs and Cost Analysis
Equipment and Supplies

Keywords

  • chronic total occlusion
  • complex coronary artery disease
  • magnetic navigation system
  • percutaneous coronary intervention
  • stereotaxis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Magnetic navigation facilitates percutaneous coronary intervention for complex lesions. / Sandhu, Gurpreet S; Sanon, Saurabh; Holmes, David; Gulati, Rajiv; Brilakis, Emmanouil S.; Lennon, Ryan J.; Rihal, Charanjit.

In: Catheterization and Cardiovascular Interventions, Vol. 84, No. 4, 01.10.2014, p. 660-667.

Research output: Contribution to journalArticle

Sandhu, Gurpreet S ; Sanon, Saurabh ; Holmes, David ; Gulati, Rajiv ; Brilakis, Emmanouil S. ; Lennon, Ryan J. ; Rihal, Charanjit. / Magnetic navigation facilitates percutaneous coronary intervention for complex lesions. In: Catheterization and Cardiovascular Interventions. 2014 ; Vol. 84, No. 4. pp. 660-667.
@article{b1b1f718ccd34cc6885a1d03c03d9f6f,
title = "Magnetic navigation facilitates percutaneous coronary intervention for complex lesions",
abstract = "Background We sought to determine the utility of a magnetic navigation system (MNS) in treating a variety of coronary artery lesions including those that could not be revascularized with standard percutaneous coronary intervention (PCI). MNS may add value in the treatment of tortuous arteries and bifurcation lesions; however its widespread adoption has lagged because of cost and a lack of clear advantage over conventional PCI. We performed a retrospective analysis to determine whether MNS improved procedural success for highly complex lesions. Methods and Results One hundred and forty-eight patients underwent treatment with MNS at Mayo Clinic, Rochester. Clinical data, angiographic and procedural characteristics, lesion crossing success and outcomes were reviewed. Overall 133 patients underwent successful revascularization with 87{\%} (143) of 164 lesions crossed using MNS alone. Another six lesions required a combination of MNS and conventional devices resulting in overall success of 91{\%} (149/164). Eighteen complex lesions had previously failed PCI and 12 (67{\%}) were successfully treated with MNS. Success after failed PCI was higher (88{\%}) when a frequent user operated MNS, but occasional users also noted incremental success (30{\%}). Twenty-five chronic total occlusions were included amongst these 164 lesions, with observed antegrade MNS lesion crossing rates of 78{\%} for regular and 14{\%} for occasional users. Conclusions MNS is a useful adjunct to performance of PCI. This specialized technology has a clear learning curve and can facilitate treatment of highly complex lesions.",
keywords = "chronic total occlusion, complex coronary artery disease, magnetic navigation system, percutaneous coronary intervention, stereotaxis",
author = "Sandhu, {Gurpreet S} and Saurabh Sanon and David Holmes and Rajiv Gulati and Brilakis, {Emmanouil S.} and Lennon, {Ryan J.} and Charanjit Rihal",
year = "2014",
month = "10",
day = "1",
doi = "10.1002/ccd.25321",
language = "English (US)",
volume = "84",
pages = "660--667",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Magnetic navigation facilitates percutaneous coronary intervention for complex lesions

AU - Sandhu, Gurpreet S

AU - Sanon, Saurabh

AU - Holmes, David

AU - Gulati, Rajiv

AU - Brilakis, Emmanouil S.

AU - Lennon, Ryan J.

AU - Rihal, Charanjit

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background We sought to determine the utility of a magnetic navigation system (MNS) in treating a variety of coronary artery lesions including those that could not be revascularized with standard percutaneous coronary intervention (PCI). MNS may add value in the treatment of tortuous arteries and bifurcation lesions; however its widespread adoption has lagged because of cost and a lack of clear advantage over conventional PCI. We performed a retrospective analysis to determine whether MNS improved procedural success for highly complex lesions. Methods and Results One hundred and forty-eight patients underwent treatment with MNS at Mayo Clinic, Rochester. Clinical data, angiographic and procedural characteristics, lesion crossing success and outcomes were reviewed. Overall 133 patients underwent successful revascularization with 87% (143) of 164 lesions crossed using MNS alone. Another six lesions required a combination of MNS and conventional devices resulting in overall success of 91% (149/164). Eighteen complex lesions had previously failed PCI and 12 (67%) were successfully treated with MNS. Success after failed PCI was higher (88%) when a frequent user operated MNS, but occasional users also noted incremental success (30%). Twenty-five chronic total occlusions were included amongst these 164 lesions, with observed antegrade MNS lesion crossing rates of 78% for regular and 14% for occasional users. Conclusions MNS is a useful adjunct to performance of PCI. This specialized technology has a clear learning curve and can facilitate treatment of highly complex lesions.

AB - Background We sought to determine the utility of a magnetic navigation system (MNS) in treating a variety of coronary artery lesions including those that could not be revascularized with standard percutaneous coronary intervention (PCI). MNS may add value in the treatment of tortuous arteries and bifurcation lesions; however its widespread adoption has lagged because of cost and a lack of clear advantage over conventional PCI. We performed a retrospective analysis to determine whether MNS improved procedural success for highly complex lesions. Methods and Results One hundred and forty-eight patients underwent treatment with MNS at Mayo Clinic, Rochester. Clinical data, angiographic and procedural characteristics, lesion crossing success and outcomes were reviewed. Overall 133 patients underwent successful revascularization with 87% (143) of 164 lesions crossed using MNS alone. Another six lesions required a combination of MNS and conventional devices resulting in overall success of 91% (149/164). Eighteen complex lesions had previously failed PCI and 12 (67%) were successfully treated with MNS. Success after failed PCI was higher (88%) when a frequent user operated MNS, but occasional users also noted incremental success (30%). Twenty-five chronic total occlusions were included amongst these 164 lesions, with observed antegrade MNS lesion crossing rates of 78% for regular and 14% for occasional users. Conclusions MNS is a useful adjunct to performance of PCI. This specialized technology has a clear learning curve and can facilitate treatment of highly complex lesions.

KW - chronic total occlusion

KW - complex coronary artery disease

KW - magnetic navigation system

KW - percutaneous coronary intervention

KW - stereotaxis

UR - http://www.scopus.com/inward/record.url?scp=84927690851&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927690851&partnerID=8YFLogxK

U2 - 10.1002/ccd.25321

DO - 10.1002/ccd.25321

M3 - Article

C2 - 24327388

AN - SCOPUS:84927690851

VL - 84

SP - 660

EP - 667

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 4

ER -