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Exit of CrossBoss between stent struts within chronic total occlusion to subintimal space: Completion of case via

Antonios Ntatsios1, William Howard Thornton Smith1

  • 1Department of Cardiology, Trent Cardiac Centre, City Campus, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.

Journal of Cardiology Cases
|December 12, 2018
PubMed

Insights

This case study details successful percutaneous coronary intervention for chronic total occlusion with in-stent restenosis. It highlights the CrossBoss catheter

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Chronic total coronary occlusions (CTOs) present a significant challenge in interventional cardiology.
  • In-stent restenosis within CTOs further complicates revascularization procedures.

Observation:

  • The CrossBoss catheter was utilized for percutaneous revascularization of a CTO with in-stent restenosis.
  • The catheter unexpectedly penetrated through stent struts into the subintimal space, a novel observation.

Findings:

  • Successful revascularization was achieved using a retrograde approach with 'rendezvous in coronary'.
  • This case is the first reported instance of the CrossBoss catheter exiting between stent struts into the subintimal space.

Implications:

  • Clinicians should be aware of the CrossBoss catheter's potential to traverse stent struts in CTOs.
  • Careful monitoring of catheter position is crucial when navigating within occluded stents.
  • The retrograde approach combined with 'rendezvous in coronary' offers a viable strategy for complex CTOs.

Keywords:
Chronic total coronary occlusionCrossBoss catheterRestenosisRetrograde approach

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