Novel CenterCross and MultiCross devices for the treatment of infrainguinal chronic total occlusions: initial
Shwan Jalal1, Thomas A Lalonde, Hiroshi Yamasaki
1St. John Hospital and Medical Center, Detroit, MI, USA.
Insights
CenterCross/MultiCross devices effectively and safely cross chronic total occlusions (CTOs) in peripheral arteries when standard guidewires fail. These novel devices offer a high success rate for complex lesion recanalization.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Chronic total occlusions (CTOs) in peripheral arteries pose significant challenges for revascularization.
- Standard guidewire techniques are often insufficient for crossing complex CTO lesions.
Purpose of the Study:
- To evaluate the effectiveness and safety of CenterCross/MultiCross devices for crossing peripheral artery CTOs.
- To assess the utility of these devices in patients unsuitable for initial standard guidewire attempts.
Main Methods:
- Single-centre study of 53 consecutive patients with infrainguinal CTOs.
- Utilized CenterCross/MultiCross devices for guidewire advancement beyond CTO lesions.
- Assessed primary endpoint of successful guidewire crossing and safety endpoints including bleeding, embolization, perforation, dissection, and emergent surgery.
Main Results:
- Successful guidewire crossing of CTO lesions achieved in 92.4% of cases.
- Average crossing time was 5.5±3.5 minutes.
- High safety profile observed: 0% bleeding/dissection/emergent surgery, 98.1% freedom from distal embolization, 96.2% freedom from perforation.
Conclusions:
- CenterCross/MultiCross devices are effective and safe for recanalizing peripheral CTO lesions resistant to conventional guidewires.
- These novel devices show promise for treating complex peripheral arterial disease lesions.
- Further research is needed to fully define the role of these devices in complex CTO treatment.
Aims:
Our aim was to evaluate the effectiveness and safety of CenterCross/MultiCross devices to facilitate the crossing of chronic total occlusions in peripheral arteries.
Methods And Results:
This was a single-centre study in which 53 consecutive patients who were not amenable to initial attempts at crossing using standard guidewires underwent an attempt to recanalise chronically occluded infrainguinal peripheral arteries with MultiCross/CenterCross devices. The primary endpoint of interest was the ability to advance the guidewire beyond the chronic total occlusion (CTO) lesions with the use of these devices. Safety endpoints were freedom from bleeding, distal embolisation and vessel perforation, dissection or need for emergent surgical intervention. Popliteal artery and below lesions were the most commonly treated, comprising 89% of the total. The CTO lesions were crossed successfully in 92.4% of the cases within a relatively short time (5.5±3.5 minutes). There was no bleeding, dissection or need for emergent surgery and 98.1% and 96.2% of the patients were free from distal embolisation and perforations, respectively.
Conclusions:
Our study demonstrated that MultiCross and CenterCross were effective and safe for recanalisation of peripheral CTO lesions which were not amenable to conventional guidewires. Further study is required to define the role of these novel devices in the treatment of complex lesions, particularly CTOs in patients with peripheral arterial disease.
