News | Chronic Total Occlusion (CTO) | November 02, 2017

Study Examines Use of CrossBoss Catheter for Chronic Total Occlusion PCI

Boston Scientific catheter yields similar crossing time, success and complication rates compared to wire escalation

Study Examines Use of CrossBoss Catheter for Chronic Total Occlusion PCI

November 2, 2017 — Crossing the occlusion with a guidewire is often the most challenging part of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), and there is debate about the optimal initial crossing strategy during the procedure. Researchers randomized 246 patients undergoing coronary CTO intervention to upfront use of the CrossBoss catheter (N=122) or wire escalation (N=124) at 11 U.S. centers. Overall technical and procedural success rates were high and similar between the two groups. The primary efficacy endpoint, crossing time, was similar: 56 (interquartile range: 33, 93) minutes in the CrossBoss and 66 (36, 105) minutes in the wire escalation group (P=0.323), as was the incidence of procedural major adverse cardiovascular events (3.28 percent vs. 4.03 percent, P= 1.000). In the CrossBoss-first strategy, the first crossing technique was more likely to be antegrade dissection/re-entry (77 percent), compared with the wire escalation strategy, which was successful as the initial strategy 98 percent of the time among patients randomized to that study arm.

Trial results were presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2017 annual conference, Oct. 29-Nov. 2 in Denver.

“The CrossBoss First trial is the first randomized-controlled trial designed to compare two commonly utilized crossing techniques as the initial CTO crossing strategy,” said Emmanouil S. Brilakis, M.D., of the Minneapolis Heart Institute. “Compared with a primary wire escalation strategy, upfront use of the CrossBoss catheter for crossing CTOs was associated with similar crossing time, similar success and complication rates, and similar equipment utilization and cost. In a post hoc analysis upfront use of the CrossBoss catheter was associated with shorter crossing time in patient with in-stent CTOs. Use of antegrade dissection/re-entry was the final successful strategy in 22 percent of the wire escalation group patients.”

The CrossBoss First study was funded by Boston Scientific. Brilakis reported consulting/speaker honoraria from Abbott Vascular, Amgen, Asahi, CSI, Elsevier, GE Healthcare and Medicure. He also disclosed research support from Boston Scientific and Osprey, and that his spouse is an employee of Medtronic.

Read about other TCT 2017 late-breaking clinical trial presentations.

For more information: www.tctconference.com

Related CTO Content

VIDEO: Treating Chronic Total Occlusions

VIDEO: New Technology to Treat Chronic Total Occlusions (CTOs)

When to Consider Revascularization of Coronary Chronic Total Occlusions

Related Content

Shockwave Announces Collaboration With Abiomed on Physician Training
News | Cath Lab | December 14, 2018
Shockwave Medical announced a new investment and collaboration agreement with Abiomed Inc. As outlined by the agreement...
Sponsored Content | Videos | Cath Lab | October 24, 2018
Michael Flaherty, M.D., discusses a study published in Circulation Research which finds that use of hemodynamic suppo
Philips Showcases Integrated Solutions for Cardiovascular Care at TCT 2018
News | Cath Lab | September 20, 2018
At the Transcatheter Cardiovascular Therapeutics (TCT) annual meeting, Sept. 21–25 in San Diego, Philips is showcasing...
Sponsored Content | Videos | Cath Lab | September 19, 2018
William O’Neill, M.D., outlines his recent clinical publication of AMICS patients from the Impella Quality (IQ) datab
A complex PCI case to revascularize a chronic total occlusion (CTO) at Henry Ford Hospital in Detroit. Complex PCI and CHIP cases are increasing patient volumes in the cath lab and using a minimally invasive approach in patients who otherwise would have been sent for CABG. Pictured is Khaldoon Alaswad, M.D. DAIC staff photo by Dave Fornell

A complex PCI case to revascularize a chronic total occlusion (CTO) at Henry Ford Hospital in Detroit. Complex PCI and CHIP cases are increasing patient volumes in the cath lab and using a minimally invasive approach in patients who otherwise would have been sent for CABG. Pictured is Khaldoon Alaswad, M.D. (right) who is proctoring a fellow in treating CTOs.

Feature | Cath Lab | September 13, 2018 | Artur Kim, Kamran Zamanian
Coronary artery disease (CAD) is a multifaceted disease that demands various approaches in terms of diagnosis and tre
Videos | Cath Lab | August 13, 2018
Jeffrey Schussler, M.D., FACC, FSCAI, FSCCT, FACP, interventional cardiologist at Baylor Scott White Heart and Vascul
Shockwave Launches Coronary Intravascular Lithotripsy in Europe
News | Cath Lab | May 30, 2018
Shockwave Medical recently announced the European commercial availability of Intravascular Lithotripsy (IVL) for...
Overlay Init