Crossing chronic total occlusions with a new 0.014 CiTop guidewire: Proof of concept

Abstract

Objective: To evaluate the feasibility of a new 0.014″ CiTop™ guidewire to cross total occlusions within normal and diseased blood vessels; proof of concept. Background: Despite recent advances, chronic arterial occlusions remain the main obstacle of coronary and peripheral interventions. Methods: The OVALUM CiTop™ 0.014″ guidewire is an over-the-wire catheter designed to penetrate through chronic total occlusions (CTO) and allow for further PCI interventions. The CiTop™ guidewire was tested in normal peripheral and coronary arteries of swine (n = 7) and in totally occluded arterial lesions within human amputations (n = 10). Results: The CiTop™ 0.014″ guidewire was operated successfully in seven peripheral blood vessels and 12 coronary arteries without angiographic or histological evidence of damage to the arterial wall. The CiTop™ crossed 9 of the 10 occluded segments within the human amputation with no angiographic or histological evidence of arterial damage (90% success rate). Average time to cross the occlusion was 4.6 ± 5.6 min. In one artery (10%), angiographic evidence of perforation was noted and there was histological evidence for arterial wall damage. Conclusion: Our data show that the new 0.014″ CiTop™ guidewire can be well operated within normal peripheral and coronary arteries of swine, and with minimal complications within totally occluded blood vessels from human amputations while effectively penetrating and crossing total arterial occlusions. © 2009 Wiley-Liss, Inc.