Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
September 16, 2026 · via Europe PMC
The Performance of High Tip Load Polymer Jacket Guidewires in Chronic Total Occlusion Revascularization.
Gurbuz AS, Ozturk S, Sural S, Tanboga HI, Aslan V, Gorgulu S.
AI summary — for doctors, generated from the abstract only
In a large retrospective study, high-tip-load polymer-jacketed guidewires for chronic total occlusion PCI achieved higher rates of antegrade recanalization, improved procedural efficiency, and a possible, though statistically tentative, reduction in perforations compared with non-polymer-jacketed penetration guidewires.
What was studied
A retrospective study of 1,850 consecutive chronic total occlusion (CTO) percutaneous coronary intervention procedures (2020-2025), comparing procedural outcomes between high-tip-load polymer-jacketed guidewires (n=220) and non-polymer-jacketed penetration guidewires (n=642), using inverse probability of treatment weighting and a propensity-matched sensitivity analysis of 208 pairs.
Key findings
- After weighting, polymer-jacketed guidewire use was associated with higher antegrade recanalization (odds ratio 1.79, 95% CI 1.06-3.02, p=0.028); procedural success was not significantly different (odds ratio 2.10, 95% CI 0.97-4.52, p=0.059).
- Procedure time and radiation exposure were lower with polymer-jacketed guidewires.
- Unadjusted perforation rates did not differ (4.1% vs 5.1%), but the propensity-matched analysis suggested fewer perforations with polymer-jacketed guidewires (3.4% vs 8.2%, odds ratio 0.39, 95% CI 0.16-0.97, p=0.042); the authors note this safety finding is based on only 24 matched events and should be considered hypothesis-generating.
- In-hospital major adverse cardiac events did not differ between groups.
Clinical relevance
This suggests high-tip-load polymer-jacketed guidewires may be a reasonable option to try for chronic total occlusion PCI before escalating to high-force penetration wires, offering comparable success with potentially better efficiency and a possible safety advantage, though the safety signal needs confirmation.
Who should care
Limitations
This was a retrospective, non-randomized design with inverse probability weighting and propensity matching to reduce confounding; the matched safety signal for perforation is based on a small number of events (24) and is explicitly described by the authors as hypothesis-generating.
High-tip-load polymer-jacketed guidewires for treating coronary chronic total occlusions achieved better recanalization rates and procedural efficiency than standard penetration wires, with a possible but still tentative safety advantage regarding perforation risk.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Guidewire selection influences chronic total occlusion (CTO) percutaneous coronary intervention (PCI) success. High-tip-load (>1.5 g) polymer-jacketed guidewires (PJWs) combine penetration capability and lubricity, but comparative data versus non-polymer-jacketed penetration wires are limited.
Aims
To compare procedural outcomes between high-tip-load PJWs and non-PJW penetration guidewires in CTO PCI.
Methods
We retrospectively analyzed 1,850 consecutive CTO PCI procedures performed between January 2020 and June 2025. The analytical cohort comprised 220 PJW and 642 non-PJW procedures. Inverse probability of treatment weighting (IPTW) adjusted for 39 covariates; a propensity-score-matched sensitivity analysis yielded 208 pairs.
Results
After IPTW adjustment, PJW use was associated with higher antegrade recanalization (OR 1.79, 95% CI 1.06-3.02; p = 0.028), whereas procedural success was not significantly different (OR 2.10, 95% CI 0.97-4.52; p = 0.059). Procedure time and air kerma were lower with PJWs. Unadjusted perforation rates did not differ (4.1% vs 5.1%; OR 0.79, 95% CI 0.37-1.67; p = 0.530), whereas the matched analysis suggested fewer perforations with PJWs (3.4% vs 8.2%; OR 0.39, 95% CI 0.16-0.97; p = 0.042). Because only 24 matched events occurred, this safety finding should be considered hypothesis-generating. In-hospital major adverse cardiac events did not differ (p = 0.954).
Conclusion
High-tip-load PJWs achieved comparable procedural success, higher antegrade recanalization, improved procedural efficiency, and a potential matched-cohort safety signal. They may be considered before escalation to high-force penetration wires.
DOI
10.1002/ccd.70885
PMID
42750308
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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