TY - JOUR
T1 - CRosser As First choice for crossing Totally occluded coronary arteries (CRAFT Registry)
T2 - Focus on conventional angiography and computed tomography angiography predictors of success
AU - García-García, Héctor M.
AU - Brugaletta, Salvatore
AU - Van Mieghem, Carlos A G
AU - Gonzalo, Nieves
AU - Diletti, Roberto
AU - Gomez-Lara, Josep
AU - Airoldi, Flavio
AU - Carlino, Mauro
AU - Tavano, Davide
AU - Chieffo, Alaide
AU - Montorfano, Matteo
AU - Michev, Iassen
AU - Colombo, Antonio
AU - Van Der Ent, Martin
AU - Serruys, Patrick W.
PY - 2011/8
Y1 - 2011/8
N2 - Aims: We investigated the use of the CROSSER catheter, a CTO crossing device based upon high frequency mechanical vibration, as a first resort to treat patients with chronic total occlusions (CTO) while describing angiographic and computed tomography coronary angiography (CTCA) serving as predictors for success. Methods and results: Eighty consecutive patients were enrolled in this prospective multicentre registry of patients treated for a CTO. For 76.3% of the patients, this was the first attempt to open the CTO. Overall success rate was 75%. By conventional coronary angiography, the length of the occlusion was 26.7±14.1 mm and there was a difference in successful vs. unsuccessful cases (24.5±13.9 and 32.8±13.1, p=0.02). The presence of angulation, as defined qualitatively, was more prevalent in failed cases (60.0% vs. 32.2%, p=0.03). The mean ratio CROSSER distance within the occlusion site and length of the occlusion showed a trend towards statistical significance in successful procedures (0.56±0.90 vs. 0.30±0.34, p=0.08). During hospitali- sation, two patients had a non-fatal myocardial infarction. One patient experienced delayed onset of tamponade six hours postprocedure. At 30 days, two patients had PCI in a non-treated vessel and one patient had a transient ischaemic attack. Relation to the CROSSER catheter was inconclusive. Conclusions: The success rate of the use of a dedicated-CTO device -the CROSSER catheter- as a first choice to open a chronic total occlusion was 75%. By multivariate analysis, in a subset of patients that were imaged with computed tomography coronary angiography, the absence of angulation was related with higher success rate.
AB - Aims: We investigated the use of the CROSSER catheter, a CTO crossing device based upon high frequency mechanical vibration, as a first resort to treat patients with chronic total occlusions (CTO) while describing angiographic and computed tomography coronary angiography (CTCA) serving as predictors for success. Methods and results: Eighty consecutive patients were enrolled in this prospective multicentre registry of patients treated for a CTO. For 76.3% of the patients, this was the first attempt to open the CTO. Overall success rate was 75%. By conventional coronary angiography, the length of the occlusion was 26.7±14.1 mm and there was a difference in successful vs. unsuccessful cases (24.5±13.9 and 32.8±13.1, p=0.02). The presence of angulation, as defined qualitatively, was more prevalent in failed cases (60.0% vs. 32.2%, p=0.03). The mean ratio CROSSER distance within the occlusion site and length of the occlusion showed a trend towards statistical significance in successful procedures (0.56±0.90 vs. 0.30±0.34, p=0.08). During hospitali- sation, two patients had a non-fatal myocardial infarction. One patient experienced delayed onset of tamponade six hours postprocedure. At 30 days, two patients had PCI in a non-treated vessel and one patient had a transient ischaemic attack. Relation to the CROSSER catheter was inconclusive. Conclusions: The success rate of the use of a dedicated-CTO device -the CROSSER catheter- as a first choice to open a chronic total occlusion was 75%. By multivariate analysis, in a subset of patients that were imaged with computed tomography coronary angiography, the absence of angulation was related with higher success rate.
KW - Chronic total occlusion
KW - Computed tomography coronary angiography
KW - Radiation exposure
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U2 - 10.4244/EIJV7I4A78
DO - 10.4244/EIJV7I4A78
M3 - Article
C2 - 21764667
AN - SCOPUS:80355126335
VL - 7
SP - 480
EP - 486
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 4
ER -