Document Detail

High-frequency vibration for the recanalization of guidewire refractory chronic total coronary occlusions.
MedLine Citation:
PMID:  19006244     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recanalization of coronary chronic total occlusions (CTOs) remains a clinical challenge, particularly when standard guidewire attempts fail. OBJECTIVES: We sought to determine the safety and efficacy of a novel method that used high-frequency (20 kHz) vibration to fragment occlusive fibrous tissue and facilitate guidewire crossing into the distal vessel. METHODS: A total of 125 patients with CTO, who failed at attempts of conventional guidewire recanalization after more than 5 min of fluoroscopy time, were enrolled in the study. The primary efficacy endpoint was the advancement of the CROSSER catheter through the occlusion and attainment of coronary guidewire positioning in the distal coronary lumen. The primary safety endpoint was the occurrence of death, myocardial infarction, clinical perforation, or target vessel revascularization within the first 30 days. RESULTS: The average fluoroscopy time while delivering the CROSSER catheter was 12.4 min. CROSSER-assisted guidewire recanalization was achieved in 76 (60.8%) procedures and a final diameter stenosis <50% was obtained in 68 (54.4%) of cases. Major adverse events occurred in 11 (8.8%) patients, lower than the predefined objective performance criteria. Angina frequency and quality of life were improved in patients with successful guidewire recanalization. CONCLUSIONS: We conclude that high-frequency vibration using the CROSSER catheter is a safe and effective therapy for patients with CTO, which are refractory to standard guidewire recanalization.
Klaus Tiroch; Louis Cannon; Mark Reisman; Ronald Caputo; Todd Caulfield; Richard Heuser; Greg Braden; Reginald Low; Gregg Stone; Alexandra Almonacid; Jeffrey J Popma
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  72     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  771-80     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Cardiovascular Division, Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  instrumentation,  methods*
Chronic Disease
Coronary Angiography
Coronary Occlusion / etiology,  radiography,  therapy*
Coronary Stenosis / complications,  radiography,  therapy*
Equipment Design
Feasibility Studies
Middle Aged
Prospective Studies
Quality of Life
Time Factors
Treatment Failure
United States
Vibration / therapeutic use*
Comment In:
Catheter Cardiovasc Interv. 2008 Nov 15;72(6):781-2   [PMID:  19009625 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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