Enhancing Guidewire Efficacy for Transradial Access: The EAGER Randomized Controlled Trial.

Humans Radial Artery / diagnostic imaging Female Male Aged Treatment Outcome Percutaneous Coronary Intervention / instrumentation Middle Aged Coronary Angiography Equipment Design Cardiac Catheters Australia Cardiac Catheterization / instrumentation Punctures Time Factors Catheterization, Peripheral / adverse effects Coronary Artery Disease / therapy Risk Factors Aged, 80 and over
aorta cardiovascular diseases fluoroscopy percutaneous coronary intervention radial artery

Journal

Circulation. Cardiovascular interventions
ISSN: 1941-7632
Titre abrégé: Circ Cardiovasc Interv
Pays: United States
ID NLM: 101499602

Informations de publication

Date de publication:
Oct 2024
Historique:
medline: 15 10 2024
pubmed: 31 8 2024
entrez: 31 8 2024
Statut: ppublish

Résumé

The 1.5 mm Baby J hydrophilic narrow J-tipped wire is a development of the standard 0.035" 3-mm J-tipped peripheral guidewire, designed to improve efficiency of transradial coronary procedures by safely navigating small caliber radial arteries to the aorta. There is currently a lack of evidence comparing the procedural success and safety of different peripheral guidewires used in transradial cardiac procedures. We compared the efficacy and safety of a narrow J-tipped hydrophilic 0.035" wire (intervention, Radifocus Baby J guidewire; TERUMO Co, Tokyo, Japan) versus a standard fixed-core 0.035" J wire (control). Investigator-initiated, blinded, Australian, multicenter randomized trial in patients undergoing clinically indicated coronary angiography or percutaneous coronary intervention. Patients were randomized 1:1 to use either the control guidewire or the intervention guidewire. The primary end point (technical success) was defined as gaining aortic root access with the randomized guidewire. In all, 330 patients were randomized between October 2022 and June 2023 (median age was 69 years, 36% were female, and body mass index was 29 kg/m A narrow 1.5 mm J-tipped hydrophilic guidewire resulted in greater technical success and reduced fluoroscopy time compared with the standard 3-mm J-tipped nonhydrophilic guidewire. The guidewire is safe and demonstrated key incremental benefits for the transradial approach, particularly in women. URL: https://www.anzctr.org.au/; Unique identifier: ACTRN12622001557729.

Sections du résumé

BACKGROUND UNASSIGNED
The 1.5 mm Baby J hydrophilic narrow J-tipped wire is a development of the standard 0.035" 3-mm J-tipped peripheral guidewire, designed to improve efficiency of transradial coronary procedures by safely navigating small caliber radial arteries to the aorta. There is currently a lack of evidence comparing the procedural success and safety of different peripheral guidewires used in transradial cardiac procedures. We compared the efficacy and safety of a narrow J-tipped hydrophilic 0.035" wire (intervention, Radifocus Baby J guidewire; TERUMO Co, Tokyo, Japan) versus a standard fixed-core 0.035" J wire (control).
METHODS UNASSIGNED
Investigator-initiated, blinded, Australian, multicenter randomized trial in patients undergoing clinically indicated coronary angiography or percutaneous coronary intervention. Patients were randomized 1:1 to use either the control guidewire or the intervention guidewire. The primary end point (technical success) was defined as gaining aortic root access with the randomized guidewire.
RESULTS UNASSIGNED
In all, 330 patients were randomized between October 2022 and June 2023 (median age was 69 years, 36% were female, and body mass index was 29 kg/m
CONCLUSIONS UNASSIGNED
A narrow 1.5 mm J-tipped hydrophilic guidewire resulted in greater technical success and reduced fluoroscopy time compared with the standard 3-mm J-tipped nonhydrophilic guidewire. The guidewire is safe and demonstrated key incremental benefits for the transradial approach, particularly in women.
REGISTRATION UNASSIGNED
URL: https://www.anzctr.org.au/; Unique identifier: ACTRN12622001557729.

Identifiants

DOI: 10.1161/CIRCINTERVENTIONS.124.014529 PMID: 39215512
pubmed: 39215512
doi: 10.1161/CIRCINTERVENTIONS.124.014529
doi:

Banques de données

ANZCTR
['ACTRN12622001557729']

Types de publication

Journal Article Randomized Controlled Trial Multicenter Study Comparative Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e014529

Commentaires et corrections

Type : CommentIn

Déclaration de conflit d'intérêts

None.

Auteurs

Adam C Bland (AC)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
School of Medicine and Public Health, The University of Newcastle, Australia (A.C.B., S.L.S., N.C., A.B., M.W., T.J.F.).
ORCID: 0000-0003-2416-9137

William Meere (W)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Philopatir Mikhail (P)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0000-0002-9199-1801

Eunice Chuah (E)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0000-0003-3482-8159

Eleanor Redwood (E)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0009-0003-8563-1353

David Ferreira (D)

Cardiology Department, John Hunter Hospital, Hunter New England Local Health District, Newcastle, Australia (D.F., N.C., A.B.).
ORCID: 0000-0003-3142-4503

Nicklas Howden (N)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Adam Perkovic (A)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0000-0001-7582-5611

Samantha L Saunders (SL)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
School of Medicine and Public Health, The University of Newcastle, Australia (A.C.B., S.L.S., N.C., A.B., M.W., T.J.F.).
ORCID: 0000-0002-9473-2012

Amy Kelty (A)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0009-0008-2379-6239

Tony Kull (T)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Andrew Hill (A)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Roberto Spina (R)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Kiran Sarathy (K)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Austin May (A)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Michael Parkinson (M)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0009-0000-3542-8638

Mark Ishak (M)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).

Nicholas Collins (N)

Cardiology Department, John Hunter Hospital, Hunter New England Local Health District, Newcastle, Australia (D.F., N.C., A.B.).
School of Medicine and Public Health, The University of Newcastle, Australia (A.C.B., S.L.S., N.C., A.B., M.W., T.J.F.).

Andrew Boyle (A)

Cardiology Department, John Hunter Hospital, Hunter New England Local Health District, Newcastle, Australia (D.F., N.C., A.B.).
School of Medicine and Public Health, The University of Newcastle, Australia (A.C.B., S.L.S., N.C., A.B., M.W., T.J.F.).
ORCID: 0000-0002-3919-5269

Maged William (M)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
School of Medicine and Public Health, The University of Newcastle, Australia (A.C.B., S.L.S., N.C., A.B., M.W., T.J.F.).

Prajith Jeyaprakash (P)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
ORCID: 0000-0001-6156-9012

Tom J Ford (TJ)

Cardiology Department, Gosford Hospital, Central Coast Local Health District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S., A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.).
School of Medicine and Public Health, The University of Newcastle, Australia (A.C.B., S.L.S., N.C., A.B., M.W., T.J.F.).
ORCID: 0000-0003-4009-6652

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Système cardiovasculaire › Vaisseaux sanguins › Artères › Artère radiale › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Procédures endovasculaires › Intervention coronarienne percutanée › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Tests de la fonction cardiaque › Coronarographie › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Techniques d'investigation › Conception d'appareillage › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Équipement et fournitures › Cathéters › Dispositifs d'accès vasculaires › Sondes cardiaques › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Techniques d'investigation › Cathétérisme › Cathétérisme cardiaque › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Procédures de chirurgie opératoire › Ponctions › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Phénomènes physiques › Temps › Facteurs temps › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Techniques d'investigation › Cathétérisme › Cathétérisme périphérique › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Ischémie myocardique › Maladie coronarienne › Maladie des artères coronaires › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Enhancing Guidewire Efficacy for Transradial...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Enhancing Guidewire Efficacy for Transradial...