When it comes to crossing chronic total occlusion (CTO), 0.010-in. guidewires seem to have potential tremendous power. In the the Prospective Multicenter Registry of IKAzuchi-X for CHronic Total OcclUsion (the PIKACHU registry), we show the welfare and efficiency of a 0.010-in. guidewire and a balloon catheter for management of CTO [8]. The PIKACHU registry is a prospective, multicenter registry study. A 0.010-in. guidewire was used as the primary guidewire to try to pass the CTO lesion. The primary endpoint included: success using a 0.010 system. The outcomes are as follows. 141 patients with one lesion each were registered. The average period of occlusion was 9 months (range 3–156). A 6 Fr. guiding catheter used in 72 cases (51.1 %) and TRI was 76.6 %. CTOs between 10 and 20 mm long, observed in 53 occlusions. There were 107 lesions (75.9 %) with bending of more than 45°. Calcification presented in 91 lesions (64.5 %). A 0.010-in. guidewire was successfully passed through in 97 of 141 lesions (68.8 %). A 0.010-in. guidewire compatible balloon catheter was passed in 87 of the 97 lesions (88.7 %) and final PCI success was achieved in all the cases. The overall experimental success rate was 87.9 % (124/141). No major adverse cardiac events (MACE) or bleeding complications were observed. This concludes the 0.010-in. catheter to be safe and practical for managing CTO lesions.

As reviewed so far, 0.010-in. guidewire have tremendous potential. To use the guidewires routinely, the safety and feasibility of the system should be confirmed. We perfumed the IKATEN Registry for assessment of this system as the main device for treating PCI [9]. The registry is a prospective, multicenter, nonrandomized registry study. Patients undergone PCI with 0.010-in. guidewire and associated balloon as the main device were registered. The co primary end- points included clinical and device success rates, the secondary endpoints were MACE and bleeding complications. The outcomes were as follows. A total of 133 patients with 148 lesions were enrolled. The majority were male (75.3 %), and mean age was 69 ± 10 years. Type B2/C lesions comprised 60 % of the lesions, CTO was 16.9 %, and bifurcation lesions were found in 22.3 % of patients. A transradial approach was used in 79.7 % of patients, and the average guiding catheter size was 5.1 ± 0.4 Fr. Clinical success rate was 99.2 %, and device success rate was 99.3 %. Device failure took place in one case of chronic total occlusion due to ineffective guidewire passage. MACE and bleeding complications were not presented besides small hematoma at the puncture site in a single patient. Stent delivery success rate on 0.010-in. guidewire was 93.9 % because of failure of stent balloon to pass eight lesions. To close, it suggests that the 0.010-in. system is without risk and is viable for routine PCI (bifurcation and CTO lesions).