Melzi Gloria, Cosgrave John, Biondi-Zoccai Giuseppe L, Airoldi Flavio, Michev Iassen, Chieffo Alaide, Sangiorgi Giuseppe M, Montorfano Matteo, Carlino Mauro, Colombo Antonio
EMO Centro Cuore Columbus, Milan, Italy.
Catheter Cardiovasc Interv. 2006 Jul;68(1):29-35. doi: 10.1002/ccd.20754.
To evaluate safety and efficacy of the CROSSER CTO Recanalization System (CROSSER).
The CROSSER, a novel device dedicated to recanalization of chronic total occlusions (CTO), relies on a monorail catheter delivering vibrational energy to facilitate the crossing of occluded coronary arteries.
We included de novo or restenotic occlusions in native coronary arteries with typically unfavorable characteristics and a prior failed guidewire attempt either performed in a previous procedure or just before the usage of the CROSSER. The end points analyzed were technical success (ability to cross or facilitate a guidewire crossing into the true lumen), angiographic success (<20% residual stenosis and TIMI flow grade 3), and clinical success (angiographic success and freedom from major adverse cardiac events at 30 days).
Twenty-eight patients (30 lesions) were included. The morphology was blunt in 83.3% and the length of the occlusion was >20 mm in 76.6%. The median age of the CTO was 9 months (range 3-60 months). Technical success was obtained in 19 (63%) occlusions and angiographic success in 16 (53%): 26.3% in lesions with prior procedural failure and 73.7% when CROSSER was attempted after initial guidewire failure. Complications were: one guidewire perforation without consequences and one peri-procedural myocardial infarction (MI). No events occurred within 30-day follow-up after discharge.
In our experience, the CROSSER System is safe and increases the success of opening CTO refractory to guidewires. This novel device may represent an useful adjunct to the armamentarium of the interventional cardiologist.
评估CROSSER慢性完全闭塞病变再通系统（CROSSER）的安全性和有效性。
CROSSER是一种专门用于慢性完全闭塞病变（CTO）再通的新型装置，依靠单轨导管传递振动能量以促进闭塞冠状动脉的穿过。
我们纳入了具有典型不利特征的原发性冠状动脉中的初发或再狭窄闭塞病变，且在先前手术中或刚在使用CROSSER之前曾尝试导丝但失败。分析的终点为技术成功（能够穿过或促进导丝穿过进入真腔）、血管造影成功（残余狭窄<20%且TIMI血流分级为3级）以及临床成功（血管造影成功且30天时无主要不良心脏事件）。
纳入了28例患者（30处病变）。83.3%的病变形态为钝性，76.6%的闭塞长度>20 mm。CTO的中位病程为9个月（范围3 - 60个月）。19处（63%）闭塞获得技术成功，16处（53%）获得血管造影成功：先前手术失败的病变中为26.3%，初始导丝失败后尝试使用CROSSER时为73.7%。并发症有：1次导丝穿孔但无后果，1次围手术期心肌梗死（MI）。出院后30天随访内未发生事件。
根据我们的经验，CROSSER系统是安全的，并且提高了开通对导丝难治的CTO的成功率。这种新型装置可能是介入心脏病学家器械库中的一种有用辅助工具。
