RECANALIZATION OF TOTAL CORONARY OCCLUSIONS USING A LASER GUIDEWIRE (THE EUROPEAN TOTAL SURVEILLANCE STUDY)

The success rates of coronary angioplasty for the treatment of chronic total occlusions are less favorable than for coronary stenosis. There fore, a new laser guidewire (LW) was designed to facilitate the crossi ng of chronic total occlusions. We report on the results of a European multicenter surveillance study, evaluating the laser guidewire perfor mance. Between May 1994 and July 1996, 345 patients (age 59 +/- 10 yea rs, 291 men) with chronic total occlusions were enrolled in 28 Europea n centers. The median age of occlusion was 29 weeks (range 2 to 884), the occlusion length 19 +/- 10 mm. LW recanalization was successful in 205 patients (59%). LW perforation occurred in 73 patients (21%), wit h hemodynamic consequences in 4 (1%). There were no deaths, emergency coronary artery bypass graft surgery, or Q-wave myocardial infarctions . In a multivariate regression analysis an occlusion age of <40 weeks (p = 0.001, RR = 1.34) and an occlusion length <30 mm (p = 0.01, RR = 1.59) were independent predictors of success. Results indicate that th e LW is an effective and safe tool in the treatment of chronic total o cclusion refractory to conventional guidewires. (C) 1997 by Excerpta M edica, Inc.