Despite marked advances in the design of percutaneous coronary intervention hardware, total occlusion remains associated with a low primary success rate. The most common cause of failure is the inability to cross the lesion with a guidewire. We report the results of a non-randomized single-center investigation using a hydrophilic coated guidewire (Crosswire NT).

We analyzed the angiographic results of 92 patients (68 males, 24 females, age 58.8±9.7 years-old) who underwent angioplasty utilizing Crosswire NT for either total (TIMI flow 1) or subtotal occlusion at Chonnam National University Hospital between December 2000 and July 2001.

Clinical diagnoses of the studied subjects revealed 40 cases of acute myocardial infarction, 15 of myocardial infarction, 29 of unstable angina and 8 of stable angina. The primary success rate was 79.3% (73/92), the success rate in total occlusion was 69.0% (40/58), and that of the chronic total occlusion cases among the total occlusion group was 64.3% (18/28). The success rates in the use of Crosswire NT as the first and second choice were 85.7% and 78.8%, respectively. The abrupt occlusive lesions, complex lesions more than type B 2, and presence of collateral circulation were all associated with a lower success rate. Coronary artery perforation occurred in one case.

The new nitinol hydrophilic wire, Crosswire NT, is a safe and effective tool for the recanalization of total occlusive coronary lesion.