Premium
Magnetic positioning system in coronary angiography and percutaneous intervention
Author(s) -
Weisz Giora,
Smilowitz Nathaniel R.,
Moses Jeffrey W.,
Rabbani LeRoy E.,
Collins Michael B.,
Herscovici Adrian,
Jeron Andreas,
Leon Martin B.,
Luchner Andreas
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24946
Subject(s) - fluoroscopy , medicine , conventional pci , percutaneous coronary intervention , catheter , radiology , coronary angiography , angiography , cardiac catheterization , cardiology , myocardial infarction
Objectives This study sought to evaluate the safety and feasibility of a magnetic medical positioning system (MPS) to determine the three‐dimensional (3D) position and orientation of intracoronary wires and catheters and to guide angiography and percutaneous coronary intervention (PCI). Background Coronary angiography relies on fluoroscopy for catheter navigation and often fails to accurately portray vessel tortuosity, overlap, and length because of complex anatomy and foreshortening of curved coronary segments. Methods Forty adult participants underwent coronary angiography and/or PCI with MPS guidance. Two interventional cardiologists independently scored (1–5) the accuracy of MPS catheter tracking projected on live fluoroscopy, recorded cine loops, and 3D vessel reconstructions. Measurements from MPS reconstructions were compared to conventional two‐dimensional (2D) quantitative coronary angiography (QCA) measurements. Device procedural success was defined as the ability of the MPS‐enabled catheter to reach the target vessel, perform the intended operations, and be retrieved without major adverse cardiac events. Results Diagnostic coronary angiography was performed in 19 (47.5%) and PCI in 21 patients (52.5%). MPS procedural success was achieved in 36 (90%) of the cases. MPS accuracy was highest with the MPS superimposed on live fluoroscopy (4.9 ± 0.2/5) and the 3D vessel reconstruction (4.7 ± 0.5/5). MPS length measurements were more accurate than conventional QCA. Conclusions This study demonstrates the feasibility and safety of magnetic catheter tracking with 3D positional data during diagnostic angiography and PCI. Catheter position was accurately projected on real‐time fluoroscopy, recorded cine loops, and 3D reconstructions. An MPS may serve as a platform for device navigation and positioning during PCI. © 2013 Wiley Periodicals, Inc.