Coronary Interventions: Distal Embolic Protection and Advanced Stent Techniques

Use of ATW Marker Wire to Guide Choice of Stent Length

J.P. Reilly, M. Grise, M. Moussavian, P. Teirstein

Scripps Clinic, La Jolla, California, USA

Background: Stent length is a risk factor for restenosis. The usual method of choosing stent size relies on visual estimation from the angiogram. The goal of this study was to assess the value of an objective means of determining stent length using a calibrated guide wire (ATW Marker wire; Cordis) as a measurement tool.

Methods: Consecutive lesions that were to undergo percutaneous intervention with stenting were prospectively evaluated. Angiography was performed in the least foreshortened projection. A visual estimate of stent length was made by the attending physician and recorded. The ATW Marker wire was then placed across the lesion. An estimate of stent length using the markers on the wire was then made and recorded. An appropriate length stent was then deployed.

Results: A total of 22 consecutive lesions were evaluated; 9 lesions were in the left anterior descending artery, 6 in the right coronary artery, 4 in the circumflex, and 3 in saphenous vein grafts. In 5 cases (22.7%) the ATW Marker wire altered the stent length chosen. In all cases, the stent length chosen after ATW Marker wire placement was longer than that which had been originally chosen by angiography before placement of the ATW Marker wire. In 1 case (4.5%) the stent that was chosen after placement of the ATW Marker wire was removed before deployment because it was deemed to be too short and therefore changed for a longer length stent.

Conclusion: The ATW Marker wire may be of aid in percutaneous intervention with stenting by providing an objective meansof determining the appropriate stent length.

Source: Am J Cardiol 2001; 88 (supp1 5A)

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