Showa University Fujigaoka Hospital

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Presentation transcript:

Showa University Fujigaoka Hospital Long CTO Case Treated with Gaia Wire Showa University Fujigaoka Hospital Kohei Wakabayashi

Kohei Wakabayashi, MD, PhD I/we have no real or apparent conflicts of interest to report.

specification/structure/performance Gaia Wire specification/structure/performance Total Length 1900mm Slip Coat Coating Length 400mm Coil Length 150mm 0.014inch PTFE First：0.010inch Second：0.011inch Two types of wire Diameter ：0.010　-　0.014” Tip load ：1.5gf Gaia First Diameter ：0.011　-　0.014” Tip load ：3.5gf Gaia Second

specification/structure/performance Gaia Wire specification/structure/performance straight tapered Gaia First 15mm 30mm Gaia Second 6mm 30mm

61 yrs, Male # Congestive Heart Failure # Stroke # Dyslipidemia # Chronic obstructive pulmonary disease (former smoker 20 ｘ 30yrs) The patient had dyspnea on effort from Sep, 2012. He was admitted because of stroke 6th, Oct. He also had congestive heart failure.

UCG LVEF 36%, LVDD 64mm inferior akinesis BNP 2220 pg/ml CTCA showed (10/10/2012) diffuse hypokinesis inferior akinesis BNP 2220 pg/ml CTCA showed

RCA #2 long CTO LAD #6 90% LCX #13 90%

PCI for long CTO CABG

XT-R Gaia-First Gaia-Second with Corsair

another day LAD and LCX were treated with DES. 4 months later UCG LVEF 47% improved inferior asynergy BNP < 400 pg/ml

Conventional CTO wires Soft wire : to find micro channel and cross Hard wire : to cross calcified lesion When the lesion was not straight, it was difficult to change the direction.

Confianza ○ Straight Curved or winding Ｘ

But Gaia

Torque force GW Test　Method

Initial torque response / 180° GW CCW R=3mm 13ページ

Tip Structure of Gaia wire Composite core : double coil structure Double coil structure gives strong torque force with flexible tip. Round core design close to tip suppresses whip. Gaia First Gaia Second Ropecoil

Micro cone-tip To keep flexibility of tip and penetration force Gaia micro-cone tip To keep flexibility of tip and penetration force 0.010”　/　0.011” Gaia micro-cone tip Conventional wire tip

Different technique to cross CTO lesion correct route Rotation Different technique to cross CTO lesion Easy to change the direction and cross

Conclusion Gaia, new generation wire, may revolute CTO treatment.