Use of ReCross to Increase Success Rate With Antegrade CTO PCI-A Multicenter Observational Study

Antegrade approach remains one of the predominant techniques for CTO PCI. Success rates have increased significantly recently due to advancements in devices and strategies, along with the hybrid algorithm. ReCross is a uniquely modified microcatheter with two over-the-wire lumens and three exit ports, offering significant potential for application across all facets of antegrade CTO-PCI applications. However, there is limited published data investigating its efficacy.

The objective of our study was to analyze the efficiency and outcome of the ReCross device, following an agreed step-by-step protocol in contemporary CTO PCI, based on our firsthand experience.

During the period between June 2023 and April 2024, we evaluated patients undergoing CTO PCI at eight participating centers for scheduled clinically necessary CTO PCI with a planned primary antegrade approach using an upfront agreed ReCross strategy.

A total of 118 patients who underwent CTO PCI were included in the study. The mean JCTO score was 2.16 ± 0.95. The majority of cases (94%) were successfully resolved using an upfront ReCross strategy with a technical success of 96%, demonstrating a high level of effectiveness. The average procedure time (90 min) observed in our study was notably lower in comparison to other similar studies. There were no procedure-related mortalities until hospital discharge, although one distal wire perforation complication was reported.

Our initial experience with the ReCross microcatheter suggests in select cases with the application of a dedicated algorithm, the antegrade approach can be highly successful.