The Feasibility and Long-Term Outcomes of the Crossboss/Stingray for Treating Coronary Chronic Total Occlusions Lesions with Distal Diffuse Disease Landing Zone

Rutao Wang^1,†, Genrui Chen^1,†, Fangjun Mou^1,†, Yi Liu¹, Zhiyong Yin¹, Bo Wang¹, Haokao Gao¹, Chao Gao¹, Ling Tao^1,*, Chengxiang Li^1,*

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¹ Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, 710032 Xi'an, Shaanxi, China

^*Correspondence: Lingtao@fmmu.edu.cn (Ling Tao); lichx1@163.com (Chengxiang Li)
^†These authors contributed equally.
Academic Editors: Christian Hengstenberg and George Dangas

Rev. Cardiovasc. Med. 2022, 23(3), 113; https://doi.org/10.31083/j.rcm2303113

Submitted: 29 November 2021 | Revised: 2 February 2022 | Accepted: 17 February 2022 | Published: 21 March 2022

(This article belongs to the Special Issue Recent Advances in Percutaneous Coronary Intervention)

This is an open access article under the CC BY 4.0 license.

Abstract

Background: The feasibility and long-term outcomes of the CrossBoss/Stingray for treating coronary chronic total occlusions (CTO) with distal diffuse disease landing zone remain unclear. Methods: Consecutive CTO patients with distal diffuse lesions that underwent percutaneous coronary intervention by the CrossBoss/Stingray system at Xijing Hospital from April 2016 to October 2020, were included. Patients were analyzed by two groups according to the extent of stenosis in the distal landing zone: 50%–70% stenosis (moderate stenosis group) and $>$ 70% stenosis (severe stenosis group). The primary efficacy outcome was technical success, defined as the frequency of true lumen guidewire placement distal to the CTO. The composite endpoint of all-cause death, any stroke, or any revascularization was also explored. Results: A total of 91 consecutive patients were included, with 32 patients in the moderate stenosis group and 59 patients in the severe stenosis group. The mean J-CTO score was 2.5 $\pm{}$ 1.1. The technical success rate was 79.1% (72/91) in the overall population and was similar between the 2 groups: 78.1% (25/32) and 79.7% (47/59) (p = 0.608). No coronary perforation occurred. With a median follow-up of 29 months (IQR: 53–92), the estimated rate of the composite endpoint of all-cause death, any stroke, or any revascularization was 50.4% (all-cause death: 16.6%, any stroke: 1.1%, any revascularization: 36.5%) in the overall population. No significant difference was observed in the rate of the composite endpoint between the moderate stenosis group and the severe stenosis group (45.1% vs. 54.3%, respectively, p = 0.797). Conclusions: In CTO lesions with distal diffuse disease landing zone, the technical success rates of CrossBoss/Stingray and the long-term clinical outcomes were not significantly different between the moderate stenosis group (50%–70%) and the severe stenosis group ( $>$ 70%). However, the relatively high rate of long-term clinical outcomes, especially any revascularization, warrants further investigations on this indication in future studies.

Keywords

chronic total occlusion

CrossBoss/Stingray

diffuse disease

landing zone

percutaneous coronary intervention

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