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Recanalization of complex coronary chronic total occlusions using high-frequency vibrational energy CROSSER catheter
Alfredo R Galassi1, Salvatore D Tomasello, Luca Costanzo
1Clinical Division of Cardiology, Department of Internal Medicine and Systemic Disease, Ferrarotto Hospital, University of Catania, Italy Etna Foundation, Catania, Italy. argalassi@virgilio.it
Insights
The CROSSER Catheter, using high-frequency vibrational energy, safely treats complex coronary total occlusions (CTOs) with high success rates. This innovative device reduces procedure time, fluoroscopy exposure, and contrast load compared to conventional methods.
Area of Science:
- Cardiovascular Interventions
- Medical Device Technology
- Interventional Cardiology
Background:
- High-frequency vibrational energy has demonstrated safety and efficacy in guidewire-refractory chronic total occlusions (CTOs).
- Complex CTOs present significant challenges in percutaneous coronary intervention.
Purpose of the Study:
- To evaluate the advantages of using the CROSSER Catheter, a high-frequency vibrational energy device, as a primary strategy for coronary complex CTO revascularization.
- To assess the safety and effectiveness of the CROSSER system in complex CTO cases.
Main Methods:
- The CROSSER Catheter was employed as the primary approach for CTO lesions exhibiting four or more unfavorable angiographic features.
- A comparative analysis was conducted between the CROSSER group and conventional CTO percutaneous coronary intervention techniques.
Main Results:
- The CROSSER system was utilized in 46 complex CTO lesions, achieving an 84.8% clinical success rate.
- No periprocedural myocardial infarction, perforation, or 30-day Major Adverse Cardiovascular Events (MACE) were observed in the CROSSER group.
- The CROSSER group experienced significantly lower procedure times, fluoroscopy times, and contrast load compared to conventional techniques.
Conclusions:
- The CROSSER System is a safe and effective tool for complex CTO revascularization, achieving success rates comparable to conventional methods.
- The use of the CROSSER Catheter offers significant benefits, including reduced procedure duration, decreased fluoroscopy exposure, and lower contrast administration.
Background:
Several studies have illustrated the safety and the procedural outcome of high-frequency vibrational energy in guidewire refractory chronic total occlusions (CTOs).
Aim:
To evaluate the advantage of high-frequency vibrational energy device (CROSSER Catheter) use in coronary complex CTO revascularization as primary strategy.
Methods:
CROSSER was used as a primary approach if four or more unfavorable angiographic features were observed in the CTO lesions.
Results:
From May 2007 to February 2009, a CTO percutaneous intervention attempt was performed in 178 lesions of 171 patients (60.1 +/- 8.9 age with 49.4 +/- 7.2% in ejection fraction). Among these, the CROSSER was used in 46 complex CTO lesions of 45 patients (25.8% of cases) and in the remaining cases, typical CTO percutaneous coronary intervention techniques were employed. Clinical success was 84.8% in CROSSER group. Moreover, in the CROSSER group, no periprocedural myocardial infarction, perforation, or 30 days MACE was observed. In addition, the use of CROSSER was associated with lower time of procedure, time of fluoroscopy, and contrast load administration as compared with conventional techniques [88 +/- 27 minutes vs 109 +/- 38 minutes (P = 0.045), 39 +/- 12 minutes vs 50 +/- 27 minutes (P = 0.032), and 334 +/- 122cc vs 408 +/- 198cc (P = 0.05), respectively].
Conclusion:
In the present study, the CROSSER System was safe and obtained a high rate of success in complex CTO similar to conventional dedicated guidewire techniques for noncomplex CTO; however, the CROSSER Catheter obtained CTO recanalization with lower contrast load administration, less time of procedure, and lower fluoroscopy exposure.
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