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Evaluation of a pressure-recording guidewire in patients with coronary arterial disease

✍ Scribed by Abildgaard, Andreas ;Kløw, Nils-Einar ;Endresen, Knut

Publisher
John Wiley and Sons
Year
1997
Tongue
English
Weight
87 KB
Volume
41
Category
Article
ISSN
0098-6569

No coin nor oath required. For personal study only.

✦ Synopsis

The accuracy and feasibility of coronary arterial pressure measurements with a 0.018-in. pressure-recording guidewire (PRGW) was evaluated in patients.

Transstenotic pressure gradients were measured with the PRGW and a guiding catheter, at baseline and during coronary vasodilatation. Proximal intracoronary pressure was measured with both systems before and after gradient measurements. Zero pressure was measured with the PRGW before and after intracoronary use.

The average of all proximal intracoronary PRGW readings were close to guiding catheter values, but there were substantial individual deviations. Average change in proximal deviation before and after gradient measurements was 21 mm Hg, standard deviation (S.D.) 7.6, range 216 to 15.

Errors in zero pressure measurements after intracoronary use (average 2.8 mm Hg, S.D. 8.8, range 29 to 35) were much greater than before use (average 0.1 mm Hg, S.D. 1.4, range 24 to 3, P F 0.001).

The PRGW was successfully introduced through an 8F guiding catheter and positioned across the stenosis in 21 of 26 attempts (81%). Intracoronary advancement of the PRGW through a double-lumen multifunctional probing catheter was successful in all nine attempts.

In conclusion, errors in PRGW-measurements caused uncertainty in gradient interpretation. However, we found the wire useful in several cases, particularly for exclusion of hemodynamically significant lesions. The steerability of the wire is inferior to ordinary guidewires, but it can be advanced to a distal intracoronary position through an over-the-wire catheter.

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