NEW YORK (Reuters Health) – Magnetic guidewire navigation is feasible in primary percutaneous coronary intervention (PCI), according to results of a noninferiority trial performed in the Netherlands.

Moreover, magnetic guidewires may cut down use of contrast media and fluoroscopy time, investigators report in the January 4 online issue of the European Heart Journal.

In magnetic guidewire navigation, two computer-controlled magnets create an adjustable magnetic field that lets the operator “precisely and actively deflect a tip-mounted magnet on an angioplasty wire,” lead author Dr. Mark S. Patterson, at the Erasmus Medical Center, Rotterdam, and colleagues explain. The operator can control the wire’s angle of approach in three dimensions.

Other potential advantages, the authors add, include the ability to maintain a coaxial vessel orientation, to avoid “eccentric lesions or thrombus,” to cannulate side branches more accurately, and to reduce wire entanglement in two-wire procedures.

Still, the investigators were concerned that the new procedure might be less efficient than convention wire techniques because it requires extra preparation and performance time. Therefore, they compared 65 consecutive patients having magnetic guidewire navigation during PCI for acute myocardial infarction with 405 historical controls who had conventional guidewire navigation.

The surgeons used the Niobe II magnetic navigation system (Stereotaxis, St Louis) and Navigant Work Station software.

There were no significant differences between groups in overall technical and procedural success (95.4% with magnetic guidewire navigation PCI vs 98.0% with conventional PCI), or in procedural time (29 vs. 31 min).

With magnetic navigation, however, use of contrast was reduced by a median of 30 mL (odds ratio, 0.41) and fluoroscopy time was shorted by a median of 7.2 minutes (OR, 0.42).

Dr. Patterson and his colleagues believe magnetic guidewire navigation “could aid the complex procedures sometimes needed in this emergent situation.”

Reference:
Eur Heart J 2010.