title: Initial clinical experience of CrossBoss catheter for in-stent chronic total occlusion lesions: A case report.
abstract: BACKGROUND
  The CrossBoss coronary chronic total occlusion (CTO) crossing catheter has been demonstrated to have greatly improved the success rate of crossing CTO lesions, but there are no published data on its application for in-stent CTO lesions.
  
  
  METHODS
  In the current study, we retrospectively reviewed the clinical data of 8 patients with in-stent CTO lesions that were managed with the CrossBoss catheter and herein we report the efficacy and safety of the CrossBoss crossing and re-entry system for this clinically challenging condition.
  
  
  RESULTS
  The CrossBoss catheter was used for 8 patients with in-stent CTO lesions, which resulted in success in 6 cases and failure in 2 cases, with a 75% success rate. Of the 6 patients with successful treatment, 5 cases had the occlusive lesions crossed with the CrossBoss catheter through a proximal lumen-to-distal lumen approach, whereas the remaining case had his occlusive lesions penetrated by the CrossBoss catheter and the guidewire. Two cases failed in treatment as the CrossBoss catheter could not cross the occlusive lesions. The 6 cases with successful treatment included 3 cases with occlusive lesions in the left anterior descending artery, 1 case with occlusive lesions in the obtuse marginal branches, and 2 cases with occlusive lesions in the right coronary artery, and the 2 cases with failure in treatment had their occlusive lesions in the right coronary artery. In addition, patients with a higher Japan chronic total occlusion score were found to have a lower success rate of crossing the occlusive lesions. None of the patients developed complications.
  
  
  CONCLUSIONS
  Our study demonstrates that the CrossBoss catheter has a high success rate and is safe for in-stent CTOs and can be recommended for this rather clinically challenging condition.
authors.affiliation: Department of Cardiology, Second Hospital of Jilin University, Changchun, Jilin Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhao
authors.forename: Long-Bo
authors.initials: LB
authors.lastname: Li
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Wang
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Shi
authors.forename: Jun-Duo
authors.initials: JD
authors.lastname: Wu
authors.forename: Ji-Chang
authors.initials: JC
authors.lastname: Zhang
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
mesh_terms: D000368:Aged; D062906:Cardiac Catheters / Q000009:adverse effects*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000209:etiology*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome