Objectives Computed tomography coronary angiography (CTCA) has been successfully integrated with the magnetic navigation system (MNS) to facilitate a roadmap-assisted percutaneous coronary intervention (PCI). The aim of this study was to compare this new approach of PCI versus conventional PCI regarding the difference of contrast usage, X-ray exposure, procedure success and the in-hospital expenses.
Methods Thirty-eight patients with stable coronary artery disease and coronary artery lesions of ≥ 70% diameter stenosis diagnosed by both pre-procedure CTCA and coronary angiography (CAG) were enrolled to receive the MNS and CT roadmap-assisted PCI. Another 38 patients were consecutively recruited to receive conventional PCI, matched with the MNS group by the vessel and lesion type base on ACC/AHA criteria.
Results Regarding the process of the guidewire placement where the technical difference of the two procedures exists in, the median contrast usage for guidewire crossing was significantly lower in the MNS group than that in the conventional group [0.0 (0.0, 3.0) vs. 5.0 (3.1, 6.8) mL; P < 0.001], with zero contrast usage in 25 of the 44 guidewire placements in the MNS group, but in none of the conventional group; the radiation dosage for guidewire crossing in the MNS group was also significantly lower than that in the conventional group [235.8 (134.9, 455.1) vs. 364.4 (223.4, 547.2) μGym2; P = 0.033]. There were no significant differences between the two groups concerning the total contrast usage, total radiation dosage of the PCI, the procedural fees, or the overall in-hospital expenses. All of the enrolled vessels were successfully intervened in both groups.
Conclusions In PCI of simple lesions, the applicaiton of CT guidance and magnetic navigation had modest impacts on radiation dosage and contrast usage for wire crossing, but no impact on overall radiation dosage or contrast usage for the procedure. In addition, the use of CT roadmap and MNS was likely more expensive compared to PCI using conventional radiographic technique.