New Coronary Guidewire Technology in Chronic Total Occlusion Percutaneous Coronary Interventions

With advancement in technology and development of treatment algorithms, the success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has increased. This improvement is at least in part due to developments in coronary guidewire technology. This chapter discusses recent developments in workhorse, polymer-jacketed, and stiff-tip guidewires that are frequently used in CTO PCI. Workhorse guidewires are used in most non-CTO PCIs and are also used during CTO PCI after successful crossing of the occlusion to minimize the risk of distal vessel injury or perforation during equipment delivery. The tip of the polymer-jacketed guidewires is fully covered by a very slippery polymer. There are three major categories of polymer-jacketed guidewires based on tip load and distal tapering: soft, non-tapered guidewires; soft, tapered polymer jacketed wires; and stiff-tip polymer jacketed wires.

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Chronic Total Occlusions: A Guide to Recanalization, Third Edition