Use of high-frequency vibrational energy in the treatment of peripheral chronic total occlusions.

Al-Ameri, Hazim; Mayeda, Guy S; Shavelle, David M

PURPOSE 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. CASE REPORTS 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. CONCLUSION The CROSSER system is an additional device that may be used to treat peripheral CTOs.