The Performance of High Tip Load Polymer Jacket Guidewires in Chronic Total Occlusion Revascularization.

Authors

Ahmet Seyfeddin Gurbuz, Semi Ozturk, Sefa Sural, Halil Ibrahim Tanboga, Vedat Aslan, Sevket Gorgulu

Published in

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. Sep 16, 2026. Epub Sep 16, 2026.

Abstract

Guidewire selection influences chronic total occlusion (CTO) percutaneous coronary intervention (PCI) success. High-tip-load (>1.5 g) polymer-jacketed guidewires (PJWs) combine penetration capability and lubricity, but comparative data versus non-polymer-jacketed penetration wires are limited.
To compare procedural outcomes between high-tip-load PJWs and non-PJW penetration guidewires in CTO PCI.
We retrospectively analyzed 1,850 consecutive CTO PCI procedures performed between January 2020 and June 2025. The analytical cohort comprised 220 PJW and 642 non-PJW procedures. Inverse probability of treatment weighting (IPTW) adjusted for 39 covariates; a propensity-score-matched sensitivity analysis yielded 208 pairs.
After IPTW adjustment, PJW use was associated with higher antegrade recanalization (OR 1.79, 95% CI 1.06-3.02; p = 0.028), whereas procedural success was not significantly different (OR 2.10, 95% CI 0.97-4.52; p = 0.059). Procedure time and air kerma were lower with PJWs. Unadjusted perforation rates did not differ (4.1% vs 5.1%; OR 0.79, 95% CI 0.37-1.67; p = 0.530), whereas the matched analysis suggested fewer perforations with PJWs (3.4% vs 8.2%; OR 0.39, 95% CI 0.16-0.97; p = 0.042). Because only 24 matched events occurred, this safety finding should be considered hypothesis-generating. In-hospital major adverse cardiac events did not differ (p = 0.954).
High-tip-load PJWs achieved comparable procedural success, higher antegrade recanalization, improved procedural efficiency, and a potential matched-cohort safety signal. They may be considered before escalation to high-force penetration wires.

PMID:
42750308
Bibliographic data and abstract were imported from PubMed on 17 Sep 2026.

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