Ayoub Mohamed, Mozid Abdul, Philip Legate, Millan Xavier, Khatri Jaikirshan, Ungureanu Claudiu, Bennett Johan, Ghafari Chadi, Avran Alexandre
Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Cardio-Respiratory Clinical Services Unit, Leeds General Infirmary, The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Catheter Cardiovasc Interv. 2025 Jul;106(1):654-662. doi: 10.1002/ccd.31585. Epub 2025 May 19.
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.
正向入路仍然是慢性完全闭塞病变经皮冠状动脉介入治疗（CTO PCI）的主要技术之一。由于设备和策略的进步以及杂交算法的应用，近期成功率显著提高。ReCross是一种独特改良的微导管，有两个导丝腔和三个出口，在正向CTO-PCI应用的各个方面都具有巨大的应用潜力。然而，关于其疗效的已发表数据有限。
我们研究的目的是根据我们的第一手经验，按照当代CTO PCI中商定的逐步方案，分析ReCross设备的效率和结果。
在2023年6月至2024年4月期间，我们评估了8个参与中心接受CTO PCI的患者，这些患者因计划进行的临床必要CTO PCI而采用预先商定的ReCross策略进行计划的主要正向入路。
共有118例接受CTO PCI的患者纳入研究。平均日本CTO评分（JCTO）为2.16±0.95。大多数病例（94%）通过预先的ReCross策略成功解决，技术成功率为96%，显示出高度的有效性。我们研究中观察到的平均手术时间（90分钟）与其他类似研究相比明显更短。直到出院没有手术相关死亡病例，尽管报告了1例远端导丝穿孔并发症。
我们使用ReCross微导管的初步经验表明，在某些病例中应用专用算法，正向入路可以非常成功。
