Optimal use of fielder XT guidewire enhances the success rate of chronic total occlusion percutaneous coronary intervention

Table 1 Parameters predicting success of chronic total occlusion-percutaneous coronary intervention

	β coefficient	Wald	Exp (β)	P-value	95%CI of OR
Clinical predictors
Sex, male	-0.559	7.780	0.572	0.016	0.363~0.902
Systolic blood pressure	0.012	6.405	1.012	0.011	1.003~1.022
NYHA class	-0.307	4.445	0.735	0.035	0.553~0.979
Contrast amount	-0.009	5,555	0.991	0.018	0.983~0.998
Lesion-related predictors
Occlusion time	-0.003	6.848	0.997	0.009	0.994~0.999
Blunt stump	-1.382	6.192	3.982	0.013	1.341~11.862
Use of Fielder XT	0.513	8.060	1.670	0.005	1.172~2.380
Constant	-5.668	0.127	0.003	0.722

NYHA: New York Heart Association; CI: Confidence interval; OR: Odds ratio.

Table 2 Clinical characteristics in the two groups, n (%)

	Overall population, n = 1230	XTgroup, n = 686	No-XT group, n = 544	P-value
Sex, male	928 (75.4)	510 (74.3)	418 (76.8)	0.313
Age, yr	61.9 ± 10.3	62.4 ± 9.9	61.3 ± 10.8	0.062
Height, cm	169.5 ± 6.3	169.2 ± 6.3	169.9 ± 6.4	0.064
Body weight, kg	74.0 ± 10.0	74.4 ± 10.7	74.2 ± 10.0	0.645
Body mass index, kg/m2	25.8 ± 3.2	26.0 ± 3.3	25.7 ± 3.1	0.112
SBP, mmHg	137.0 ± 20.8	137.7 ± 20.6	136.0 ± 21.0	0.146
DBP, mmHg	81.0 ± 12.9	81.3 ± 13.1	80.6 ± 12.7	0.365
Hypertension	765 (62.2)	429 (62.5)	336 (61.8)	0.782
Diabetes mellitus	405 (32.9)	226 (32.9)	179 (32.9)	0.988
Previous stroke	95 (7.7)	50 (7.3)	45 (8.3)	0.521
OMI	408 (33.2)	232 (33.8)	176 (32.4)	0.587
Previous PCI	328 (26.7)	189 (27.6)	139 (25.6)	0.431
PRI	119 (9.7)	63 (9.2)	56 (10.3)	0.513
Smoking	693 (56.3)	378 (55.1)	315 (57.9)	0.325
Alcohol drinking	445 (36.2)	247 (36.0)	198 (36.4)	0.887
LVEF, %	60.0 ± 9.0	60.0 ± 9.0	59.8 ± 8.6	0.587
LVEDd, mm	48.4 ± 6.3	48.5 ± 6.4	48.3 ± 6.2	0.559
Serum creatinine, μmol/L	73.0 ± 23.0	72.5 ± 23.9	71.8 ± 21.6	0.577
Cardiothoracic ratio, %	54.0 ± 6.0	53.8 ± 6.1	53.2 ± 6.0	0.089
NYHA heart function class				0.643
Class I	923 (75.0)	510 (74.3)	413 (75.9)
Class II	247 (20.1)	144 (21.0)	103 (18.9)
Class III	60 (4.9)	32 (4.7)	28 (5.1)
Age ≥ 65 yr	532 (43.3)	292 (42.6)	240 (44.1)	0.585

Values represent the mean ± SD or number of patients and proportion (%). SBP: Systolic blood pressure; DBP: Diastolic blood pressure; OMI: Old myocardial infarction; PRI: Previous renal insufficiency; PCI: Percutaneous coronary intervention; LVEF: Left ventricular ejection fraction; LVEDd: Left ventricular end-diastolic diameter; NYHA: New York Heart Association.

Table 3 Lesion-related characteristics in the two groups, n (%)

	Overall population, n = 1230	XT group, n = 686	No-XT group, n = 544	P-value
Multivessel CAD	530 (43.1)	300 (43.7)	230 (42.3)	0.609
LC	170 (13.8)	90 (13.1)	80 (14.7)	0.423
Tortuosity	105 (10.2)	57 (11.7)	48 (8.8)	0.124
Bridging collaterals	95 (7.7)	55 (8.0)	40 (7.4)	0.665
Blunt stump	107 (8.7)	61 (8.9)	46 (8.5)	0.787
J-CTO score				0.077
0	597 (48.5)	332 (48.4)	265 (48.7)
1	507 (41.2)	282 (41.1)	225 (41.4)
2	99 (8.0)	50 (7.3)	49 (9.0)
3	23 (1.9)	19 (2.8)	4 (0.7)
4	4 (0.3)	3 (0.4)	1 (0.2)
Rentrop class				0.686
0	233 (18.9)	126 (18.4)	107 (19.7)
1	220 (17.9)	117 (17.1)	103 (18.9)
2	434 (35.3)	245 (35.7)	189 (34.7)
3	343 (27.9)	198 (28.9)	145 (26.7)
CTO vessel				0.570
LM	1 (0.1)	1 (0.1)	0 (0)
LAD	545 (44.3)	302 (44.0)	243 (44.7)
LCX	173 (14.1)	103 (15.0)	70 (12.9)
RCA	511 (41.5)	280 (40.8)	231 (42.5)
Occlusion length, mm	21.6 ± 14.8	21.5 ± 15.1	21.7 ± 14.5	0.876
Occlusion time, mo	82.3 ± 27.1	45.9 ± 60.0	45.0 ± 50.9	0.796

Values represent the mean ± SD or number of patients and proportion (%). CAD: Coronary artery disease; LC: Lesion calcification; J-CTO: Multicenter CTO Registry in Japan; rentrop class definition: Class 1, filling of side branches of the artery via collateral channels without visualization of the epicardial segment; Class 2, partial filling of the epicardial segment via collateral channels; Class 3, complete filling of the epicardial segment of the artery via collateral channels; CTO: Chronic total occlusion; LM: Left main artery; LAD: Left anterior descending artery; LCX: Left circumflex artery; RCA: Right coronary artery.

Table 4 Procedural outcomes and in-hospital complications in the two groups

	Overall population, n = 1230	XTgroup, n = 686	No-XT group, n = 544	P-value
Stent length, mm	34.3 ± 16.8	32.0 ± 15.8	37.3 ± 17.6	< 0.001
Contrast amount, mL	156.1 ± 45.6	148 ± 46	166 ± 43	< 0.001
Side branch loss	75 (6.1)	31 (4.5)	44 (8.1)	0.009
CIN	69 (5.6)	29 (4.2)	40 (7.4)	0.018
Coronary artery rupture	11 (0.9)	3 (0.4)	8 (1.5)	0.056
No reflow	22 (1.9)	8 (1.2)	14 (2.9)	0.034
Post-PCI MI	102 (8.3)	43 (6.3)	59 (10.8)	0.004
In-hospital death	8 (0.7)	2 (0.3)	6 (1.1)	0.079
TLR	10 (0.8)	3 (0.4)	7 (1.3)	0.099
MACE	101 (8.3)	44 (6.4)	57 (10.7)	0.007
Success rate	1032 (83.9)	602 (87.8)	430 (79.0)	< 0.001
Procedure time, min	78 ± 23	74 ± 23	83 ± 21	< 0.001

Values represent the mean ± SD or number of patients and proportion (%). CIN: Contrast-induced nephropathy; MI: Myocardial infarction; PCI: Percutaneous coronary intervention; TLR: Target lesion revascularization; MACE: Major adverse cardiovascular event.