The use of soft and flexible guidewires in the treatment of chronic total coronary occlusions by activated guidewire angioplasty

Activated guidewire angioplasty (AGA) is a new technique which has been des igned to assist in angioplasty of total occlusions. The purpose of this stu dy was to determine the safety and efficacy of using flexible relatively so ft guidewires (floppy wires) in conjunction with this technique and also to determine the predictors of lesion crossing and final success by this tech nique in patients with chronic total coronary occlusions. 73 patients with 73 chronic total coronary occlusions in whom coronary angioplasty using con ventional techniques had failed were treated with ACA using floppy guidewir es. The success of crossing these lesions was 65.7% (48/73) resulting in a final angioplasty success of 56.1% (41/73). Angioplasty success was reduced compared with crossing success in seven arteries in which complications oc curred during balloon angioplasty. Multiple stepwise logistic regression an alysis identified the location of the occlusion (right coronary artery, p=0 .005) as independent predictor of crossing success of this technique and th e male gender (p=0.03), the duration of occlusion (p=0.05), the lesion leng th (p=0.01) and the location of the occlusion (right coronary artery, p=0.0 2) as independent predictors of final procedural success of the method.