Real-Time Aspiration-Enabled Dual Over-the-Wire Microcatheter Enhances Parallel Wire Technique in Chronic Total Occlusion Recanalization.

Authors

Xin Zhong, Yong Dong, Chenhai Xia, Xiwen Zhang, Changlin Zhai, Bin Nie, Liang Xu, Yujie Zhao, Junbo Ge, Lei Yin, Tao Hu

Published in

JACC. Asia. Volume 6. Issue 9. Pages 2053-2062.

Abstract

Suboptimal parallel wire technique (PWT) success rates result primarily from progressive subintimal hematoma expansion during procedural maneuvers in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
The aim of this study was to evaluate the procedural outcomes of a novel dual over-the-wire engineered, subintimal hematoma aspiration-enabled dual-lumen microcatheter (DLMC) assisted PWT in CTO PCI.
One hundred consecutive CTO PCI cases using the PWT were retrospectively analyzed, comparing outcomes between a conventional DLMC (Conv-DLMC) and a H.STARFISH (real-time [RT] aspiration DLMC) assisted PWT.
Reattempt cases constituted 31.0% of all procedures (31 of 100). In the RT aspiration DLMC group, 13 of 50 cases (26.0%) crossed over after Conv-DLMC failure. Hematoma aspiration was performed in 70.0% (35 of 50) of the RT aspiration DLMC group and in 100% of cases (13 of 13) switched from failed Conv-DLMC attempts. PWT success rates were significantly higher with RT aspiration DLMC (98.0% [49 of 50]; 95% CI: 89.4%-99.9%) vs Conv-DLMC (78.0% [39 of 50]; 95% CI: 64.0%-88.5%) (P < 0.001). Although median PWT duration showed no significant difference (RT aspiration DLMC vs Conv-DLMC: 22.0 minutes [Q1-Q3: 10.8-51.0 minutes] vs 23.5 minutes [Q1-Q3: 12.0-36.3 minutes]; P = 0.735), prolonged PWT attempts (>45 minutes) occurred more frequently in the RT aspiration DLMC group than the Conv-DLMC group (30.0% [15 of 50] vs 12.0% [6 of 50]; P = 0.027), with a maximum duration of 147 minutes recorded in the RT aspiration DLMC group. Meanwhile, the Conv-DLMC group required a higher rate of strategy switching to retrograde approach (4.0% [2 of 50] vs 22.0% [11 of 50]; P = 0.007). No major complications occurred in either group.
The RT aspiration DLMC was able to improve PWT success rates in CTO PCI and enable prolonged PWT attempts because of its RT hematoma aspiration capability.

PMID:
42683957
Bibliographic data and abstract were imported from PubMed on 02 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.