title: Use of high-frequency vibrational energy in the treatment of peripheral chronic total occlusions.
abstract: OBJECTIVE
  Peripheral chronic total occlusions (CTO) are challenging lesions to treat. The CROSSER system (FlowCardia, Sunnyvale, CA) uses high-frequency low-amplitude vibrations to break through the cap of the CTO and had been shown to be successful in coronary CTOs. This is a case series demonstrating the use of the CROSSER system with peripheral CTOs.
  
  
  METHODS
  Three patients with peripheral CTO of various lengths, locations, and complexities were treated with the CROSSER system. The device allowed placement of a guidewire across the area of occlusion, thus permitting further percutaneous intervention. The CROSSER system was effective with both ostial and distal lesions, tapered and abrupt lesion morphologies, and was used from both an ipsilateral (antegrade access) and contralateral approach.
  
  
  CONCLUSIONS
  The CROSSER system is an additional device that may be used to treat peripheral CTOs.
authors.affiliation: The Heart Institute, Good Samaritan Hospital, Los Angeles, California, USA.
authors.forename: Hazim
authors.initials: H
authors.lastname: Al-Ameri
authors.forename: Guy S
authors.initials: GS
authors.lastname: Mayeda
authors.forename: David M
authors.initials: DM
authors.lastname: Shavelle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*