Integration of dual source computed tomography With magnetic navigation system for percutaneous coronary intervention: A feasibility study

Objectives : To investigate the feasibility of integration of the dual source computed tomography (DSCT) and magnetic navigation system (MNS) to guide percutaneous coronary intervention (PCI). Background : MNS has proven to be feasible for yielding high rates of procedural success for PCI. DSCT coronary angiography (DSCT‐CA) may provide a roadmap of a target vessel and serve as a reference route for MNS. Combination of these two technologies might decrease the contrast use, fluoroscopy exposure, and be beneficial to the intervention of the totally occluded lesions. Methods : Twenty‐five patients with positive results of DSCT‐CA and indications for PCI were included. CT images were transferred to MNS, and target vessels were extracted and registered to X‐ray system as a roadmap. Results : DSCT‐CA and MNS‐assisted PCIs were successfully performed in 25 of the 26 target vessels (96.2%), with the mean guidewire crossing time of 100.0 (25–75% inter‐quartile ranges (IQR): 70.7–157.8) sec, mean total radiation dosage of 268.1 (IQR: 150.5–527.0) μGym², or 42.0 (IQR: 23.0–70.0) mGy, respectively. The contrast usage for guidewire positioning was 0 (IQR: 0–3.0) ml for the successfully crossed lesions. Both of the two totally occluded lesions in this study were successfully crossed with guidewires under the guidance of the DSCT‐CA derived roadmap. Conclusion : Integration of DSCT with MNS for PCI is feasible. This integration of advanced modalities might decrease contrast usage, lower fluoroscopy exposure for guidewire positioning, and might also play a role in totally occluded lesions. © 2011 Wiley Periodicals, Inc.