title: A novel approach to infrainguinal arteries with chronic total occlusions using the high frequency vibrational device.
abstract: BACKGROUND
  Endovascular treatment (EVT) for chronic total occlusion (CTO) is a technically challenging problem in peripheral arterial disease (PAD). The Crosser system is a CTO device with high frequency vibrational energy to cross the CTO, which has been adopted for coronary CTO. We performed EVT procedure by the device for PAD with CTO, and the purpose of this study was to evaluate the efficacy and safety of a high-frequency vibrational device, the Crosser™ system, in the EVT for the infrainguinal arteries with CTO.
  
  
  METHODS
  From April 2014 to September 2014, 16 patients with 19 sites of infrainguinal CTO underwent EVT with the Crosser™ system and technique. CTO was defined as 100% occlusion of the vessel, and technical success was defined as the device's ability to facilitate the successful intraluminal delivery of the guidewire into the distal vessel. In addition, we evaluated the postoperative complications, including device-related complications.
  
  
  RESULTS
  We treated 16 patients (12 males; mean age, 68±7 years) with a mean lesion length of CTO of 150±85 mm. A technical success rate of 84% was achieved, and no device-related complications were observed, including dissection and perforation. Technical failure was associated with hemodialysis and calcification of grade 3 (P=0.029 and 0.047, respectively).
  
  
  CONCLUSIONS
  The Crosser™ system is a safe and effective treatment option for cases of infrainguinal CTO, without complications.
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan - igari.srg1@tmd.ac.jp.
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Igari
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kudo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyofuku
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000368:Aged; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000601:surgery*; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*