title: CRosser As First choice for crossing Totally occluded coronary arteries (CRAFT Registry): focus on conventional angiography and computed tomography angiography predictors of success.
abstract: OBJECTIVE
  We investigated the use of the CROSSER catheter, a CTO crossing device based upon high frequency mechanical vibration, as a first resort to treat patients with chronic total occlusions (CTO) while describing angiographic and computed tomography coronary angiography (CTCA) serving as predictors for success.
  
  
  RESULTS
  Eighty consecutive patients were enrolled in this prospective multicentre registry of patients treated for a CTO. For 76.3% of the patients, this was the first attempt to open the CTO. Overall success rate was 75%. By conventional coronary angiography, the length of the occlusion was 26.7±14.1 mm and there was a difference in successful vs. unsuccessful cases (24.5±13.9 and 32.8±13.1, p=0.02). The presence of angulation, as defined qualitatively, was more prevalent in failed cases (60.0% vs. 32.2%, p=0.03). The mean ratio CROSSER distance within the occlusion site and length of the occlusion showed a trend towards statistical significance in successful procedures (0.56±0.90 vs. 0.30±0.34, p=0.08). During hospitalisation, two patients had a non-fatal myocardial infarction. One patient experienced delayed onset of tamponade six hours postprocedure. At 30 days, two patients had PCI in a non-treated vessel and one patient had a transient ischaemic attack. Relation to the CROSSER catheter was inconclusive.
  
  
  CONCLUSIONS
  The success rate of the use of a dedicated-CTO device--the CROSSER catheter--as a first choice to open a chronic total occlusion was 75%. By multivariate analysis, in a subset of patients that were imaged with computed tomography coronary angiography, the absence of angulation was related with higher success rate.
authors.affiliation: Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. hgarcia@cardialysis.nl
authors.forename: Héctor M
authors.initials: HM
authors.lastname: García-García
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Carlos A G
authors.initials: CA
authors.lastname: van Mieghem
authors.forename: Nieves
authors.initials: N
authors.lastname: Gonzalo
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.forename: Flavio
authors.initials: F
authors.lastname: Airoldi
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Davide
authors.initials: D
authors.lastname: Tavano
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Matteo
authors.initials: M
authors.lastname: Montorfano
authors.forename: Iassen
authors.initials: I
authors.lastname: Michev
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Martin
authors.initials: M
authors.lastname: van der Ent
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002305:Cardiac Tamponade / Q000209:etiology; D057785:Catheters; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D007558:Italy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009426:Netherlands; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome