Randomized Comparison of a CrossBoss First Versus Standard Wire Escalation Strategy for Crossing Coronary Chronic Total Occlusions

Karácsonyi, Judit; Tajti, Péter; Rangan, Bavana V.; Halligan, Sean; Allen, Raymond H.; Nicholson, William J.; Harvey, James E.; Spaedy, Anthony; Jaffer, Farouc A.; Grantham, J. Aaron; Salisbury, Adam C.; Hart, Anthony; Safley, David M.; Lombardi, William; Hira, Ravi S.; Don, Creighton W.; McCabe, James M.; Burke, M. Nicholas; Alaswad, Khaldoon; Koenig, Gerald; Sanghvi, Kintur; Ice, Daniel S.; Kovach, Richard; Varghese, Vincent; Murad, Bilal; Baran, Kenneth W.; Resendes, Erica; Martinez‐Parachini, Jose Roberto; Karatasakis, Aris; Danek, Barbara Anna; Iwnetu, Rahel; Roesle, Michele; Khalili, Houman; Banerjee, Subhash; Brilakis, Emmanouil S.

doi:10.1016/j.jcin.2017.10.023

Cited by 49 publications

(19 citation statements)

References 22 publications

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“…The CrossBoss First trial was a multicenter, randomized-controlled trial that compared upfront use of the CrossBoss microcatheter (Boston Scientific) versus standard wire escalation for antegrade CTO crossing. 5 This study included 246 patients and showed no difference in procedural success, procedure time or equipment cost suggesting that either approach is reasonable. Werner et al performed a randomized trial in 396 patients to assess symptomatic improvement with CTO PCI.…”

Section: Chronic Total Occlusionsmentioning

confidence: 82%

Percutaneous Coronary Intervention: Developments in the Last 12 Months

Davies

Abbott

2019

US Cardiology Review

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In 2018, there were several studies that significantly added to the field of interventional cardiology. Research was focused on understanding the role of percutaneous coronary intervention (PCI) in various clinical syndromes, optimizing outcomes for high-risk lesion subsets, and building an evidence base for greater adoption of PCI guided by physiology and intracoronary imaging. In the area of innovation, novel and iterative developments in drug-eluting stents (DES) and scaffold platforms were compared with current generation DES. This article summarizes the research from last year which has had the most impact on PCI techniques and clinical care.

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Section: Chronic Total Occlusionsmentioning

confidence: 82%

Percutaneous Coronary Intervention: Developments in the Last 12 Months

Davies

Abbott

2019

US Cardiology Review

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“…The CrossBoss First trial compared upfront use of the CrossBoss catheter with AWE for CTO crossing. 88 It demonstrated similar crossing time, success and complication rates, and costs, suggesting that both strategies are acceptable as an initial approach. Crossing time was shorter with upfront use of the CrossBoss catheter in in-stent restenotic lesions.…”

Section: Use Of Dissection/reentry Strategiesmentioning

confidence: 85%

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Tajti

Brilakis

2018

JAHA

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“…The solution depends on whether the caps are within, proximal, or distal to the stent, as shown. For lesions with both caps contained in the stent, a CrossBoss (Boston Scientific) is an excellent initial strategy as it will likely cross the distal cap in‐stent . If the CrossBoss will not advance through the stented segment (often due to a stent strut or edge), it can be wire‐redirected into the CTO body.…”

Section: In‐stent Cto Algorithmmentioning

confidence: 99%

Algorithmic solutions to common problems encountered during chronic total occlusion angioplasty: The algorithms within the algorithm

Riley

Walsh

Kirtane

et al. 2018

Cathet Cardio Intervent

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Improved technical equipment, dissemination of best practices, and the importance of complete coronary revascularization have led to a renewed interest in coronary chronic total occlusion (CTO) PCI. In particular, the hybrid algorithm has been associated with increasing procedural success rates in the US. However, the hybrid algorithm only covers overarching strategies in the overall approach to these lesions. Several technical challenges can occur during execution of these approaches, each of which has several potential solutions. A systematic or algorithmic approach to dealing with these challenges could contribute to improved procedural efficiency and higher procedural success. While there have been isolated attempts in the past to codify approaches to each of these situations, there has not been a contemporary, comprehensive review of the potential solutions to these problems. We present 10 common problems encountered during CTO PCI and a consensus hierarchical approach to them. K E Y W O R D S consensus, percutaneous coronary intervention, solutions The hybrid algorithm for selecting crossing strategies for coronary chronic total occlusions (CTOs) was initially reported in 2012 via consensus of high volume CTO PCI operators (Figure 1) 1 . In essence, the algorithm is predicated on four angiographic features seen on dual catheter angiography: (1) anatomy of the lesion's proximal and distal caps, (2) anatomy of the vessel distal to the lesion's distal cap, (3) the presence of useable collaterals, and (4) the length of the lesion occlusion segment. The first three inform the operator whether to start

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Randomized Comparison of a CrossBoss First Versus Standard Wire Escalation Strategy for Crossing Coronary Chronic Total Occlusions

Abstract: As compared with wire escalation, upfront use of the CrossBoss catheter for antegrade crossing of coronary chronic total occlusions was associated with similar crossing time, similar success and complication rates, and similar equipment use and cost.

Cited by 49 publications

References 22 publications

Percutaneous Coronary Intervention: Developments in the Last 12 Months

Percutaneous Coronary Intervention: Developments in the Last 12 Months

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Algorithmic solutions to common problems encountered during chronic total occlusion angioplasty: The algorithms within the algorithm

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