Objectives: To evaluate safety and efficacy of the CROSSER CTO Recanalization System (CROSSER).
Background: 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.
Methods: 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).
Results: 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.
Conclusions: 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.
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http://dx.doi.org/10.1002/ccd.20754 | DOI Listing |
JBJS Essent Surg Tech
May 2024
Radboud University Medical Center, Nijmegen, The Netherlands.
Background: This video article describes the use of bone-anchored prostheses for patients with transtibial amputations, most often resulting from trauma, infection, or dysvascular disease. Large studies have shown that about half of all patients with a socket-suspended artificial limb experience limited mobility and limited prosthesis use because of socket-related problems. These problems occur at the socket-residual limb interface as a result of a painful and unstable connection, leading to an asymmetrical gait and subsequent pelvic and back pain.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Interventional Cardiology, Vall d'Hebron Hospital, Barcelona, Spain.
Percutaneous coronary intervention (PCI) in pediatric patients is rare, especially in cases of chronic total occlusion (CTO) of the left main coronary artery (LMCA), with scarce evidence. These are associated with poorer prognostic outcomes, highlighting the need for timely intervention. In addition, its unique and entirely different pathophysiology compared to that well-studied in adults makes it a clinically challenging scenario for diagnosis, treatment, and follow-up.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Section of Cardiovascular Diseases, White River Health, Batesville, Arkansas, USA.
Patients presenting with acute coronary syndrome with ST-segment elevation myocardial infarction require rapid and decisive interventions to restore blood flow to the affected myocardium, minimizing ischemic damage. This case report is particularly unique because it involves a patient presenting with ST-segment elevation myocardial infarction, where the culprit lesion was an occluded coronary artery graft with an extensive thrombus burden. The complexity of this case necessitated a strategic shift to revascularize the chronically occluded native vessel instead of the graft.
View Article and Find Full Text PDFObjectives: More than 20% of patients experience chronic lateral ligamentous instability of the ankle (CLLIOTA) following the appropriate management of an ankle sprain. The modified Broström-Gould (MBG) procedure has become the standard treatment for the anatomic repair of symptomatic CLLIOTA.
Methods: This retrospective, single-group study included all patients with CLLIOTA who underwent surgery using the MBG technique in Shahid Kamyab Hospital, Mashhad, Iran, between July 2015 and August 2020.
Mediterr J Rheumatol
December 2024
Department of Paediatric Medicine.
Background: To assess the association between Neutrophil-to-lymphocyte ratio (NLR) and Platelet-to-lymphocyte ratio (PLR) with a degree of activity of paediatric systemic lupus erythematosus (pSLE) in terms of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) score.
Methods: This observational cross-sectional study was conducted in Paediatric Rheumatology Clinic, Medical College Kolkata. Systemic lupus erythematosus was diagnosed in children based on the 2019 EULAR/ACR criteria and/or SLICC 2012 criteria.
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