TY - JOUR
T1 - Randomized Comparison of a CrossBoss First Versus Standard Wire Escalation Strategy for Crossing Coronary Chronic Total Occlusions
T2 - The CrossBoss First Trial
AU - Karacsonyi, Judit
AU - Tajti, Peter
AU - Rangan, Bavana V.
AU - Halligan, Sean C.
AU - Allen, Raymond H.
AU - Nicholson, William J.
AU - Harvey, James E.
AU - Spaedy, Anthony J.
AU - Jaffer, Farouc A.
AU - Grantham, J. Aaron
AU - Salisbury, Adam
AU - Hart, Anthony J.
AU - Safley, David M.
AU - Lombardi, William L.
AU - Hira, Ravi
AU - Don, Creighton
AU - McCabe, James M.
AU - Burke, M. Nicholas
AU - Alaswad, Khaldoon
AU - Koenig, Gerald C.
AU - Sanghvi, Kintur A.
AU - Ice, Daniel
AU - Kovach, Richard C.
AU - Varghese, Vincent
AU - Murad, Bilal
AU - Baran, Kenneth W.
AU - Resendes, Erica
AU - Martinez-Parachini, Jose R.
AU - Karatasakis, Aris
AU - Danek, Barbara A.
AU - Iwnetu, Rahel
AU - Roesle, Michele
AU - Khalili, Houman
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2018 American College of Cardiology Foundation
PY - 2018/2/12
Y1 - 2018/2/12
N2 - Objectives: The authors performed a multicenter, randomized-controlled, clinical trial comparing upfront use of the CrossBoss catheter versus antegrade wire escalation for antegrade crossing of coronary chronic total occlusions. Background: There is equipoise about the optimal initial strategy for crossing coronary chronic total occlusions. Methods: The primary endpoints were the time required to cross the chronic total occlusion or abort the procedure and the frequency of procedural major adverse cardiovascular events. The secondary endpoints were technical and procedural success, total procedure time, fluoroscopy time required to cross and total fluoroscopy time, total air kerma radiation dose, total contrast volume, and equipment use. Results: Between 2015 and 2017, 246 patients were randomized to the CrossBoss catheter (n = 122) or wire escalation (n = 124) at 11 U.S. centers. The baseline clinical and angiographic characteristics of the study groups were similar. Technical and procedural success were 87.8% and 84.1%, respectively, and were similar in the 2 groups. Crossing time was similar: 56 min (interquartile range: 33 to 93 min) in the CrossBoss group and 66 min (interquartile range: 36 to 105 min) in the wire escalation group (p = 0.323), as was as the incidence of procedural major adverse cardiovascular events (3.28% vs. 4.03%; p = 1.000). There were no significant differences in the secondary study endpoints. Conclusions: 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.
AB - Objectives: The authors performed a multicenter, randomized-controlled, clinical trial comparing upfront use of the CrossBoss catheter versus antegrade wire escalation for antegrade crossing of coronary chronic total occlusions. Background: There is equipoise about the optimal initial strategy for crossing coronary chronic total occlusions. Methods: The primary endpoints were the time required to cross the chronic total occlusion or abort the procedure and the frequency of procedural major adverse cardiovascular events. The secondary endpoints were technical and procedural success, total procedure time, fluoroscopy time required to cross and total fluoroscopy time, total air kerma radiation dose, total contrast volume, and equipment use. Results: Between 2015 and 2017, 246 patients were randomized to the CrossBoss catheter (n = 122) or wire escalation (n = 124) at 11 U.S. centers. The baseline clinical and angiographic characteristics of the study groups were similar. Technical and procedural success were 87.8% and 84.1%, respectively, and were similar in the 2 groups. Crossing time was similar: 56 min (interquartile range: 33 to 93 min) in the CrossBoss group and 66 min (interquartile range: 36 to 105 min) in the wire escalation group (p = 0.323), as was as the incidence of procedural major adverse cardiovascular events (3.28% vs. 4.03%; p = 1.000). There were no significant differences in the secondary study endpoints. Conclusions: 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.
KW - CrossBoss
KW - antegrade dissection/re-entry
KW - antegrade wire escalation
KW - chronic total occlusion
KW - percutaneous coronary intervention
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UR - http://www.scopus.com/inward/citedby.url?scp=85041909022&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2017.10.023
DO - 10.1016/j.jcin.2017.10.023
M3 - Article
C2 - 29413236
AN - SCOPUS:85041909022
SN - 1936-8798
VL - 11
SP - 225
EP - 233
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 3
ER -