Abstract 4163: Corsair First-In-Man (FIM) Registry: Safety and Efficacy of a Novel Metal Catheter in Chronic Total Occlusion Lesions
Background: Successful recanalization of chronic total occlusions (CTO) in native coronary arteries continues to represent the most technically challenging aspect of percutaneous coronary intervention (PCI). A retrograde approach through the collateral channels has recently been proposed and has the potential to improve on the success rates of PCI in CTO lesions of the coronary arteries. The aim of this study was to evaluate the safety and feasibility of a novel metal catheter (CORSAIR) in the retrograde approach for CTO recanalization.
Methods: We sought to evaluate the safety and efficacy of this device in retrograde collateral tracking for CTO lesions. From September 2007 to September 2008, CTO recanalization was attempted using CORSAIR in 93 consecutive CTO lesions (>3 months). Clinical outcomes were compared with a matched control group (n=93).
Results: Of 93 cases, CTO recanalization was previously attempted in 61 (65%). CTO lesions were most frequently located in the RCA (80%) followed by the LAD (17%), and the LCX (3%). For the retrograde approach with CORSAIR, we used septal channels (83%), epicardial channels (15%), and bypass grafts (2%) as an access route. No significant difference was observed in baseline lesion characteristics between the 2 groups. The rates of successful channel crossing and access into the CTO with CORSAIR were 97% and 91%, respectively. Successful recanalization was achieved in 98% of the cases (91% in matched controls, p=0.03) without any major cardiac events or complications such as hematoma or coronary rupture.
Conclusions: In this FIM study, CORSAIR provided a high success rate for PCI via the retrograde approach for CTO lesions without major complications. These results indicate that this novel device is feasible to use and safe in retrograde approach. Additional clinical trials should be considered to confirm these promising results.