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Coronary CTO Re-Entry System

The Hybrid Approach to Treating CTOs

Treat Even the Most Complex Lesions Safely, with Maximum Efficiency and Success

The Algorithm Emphasizes:

  • Procedural efficiency and minimizing the amount of radiation and contrast
  • Quick transition to alternate plans when failure mode occurs; always make progress — don’t let the case stall
New techniques and technologies, including the CrossBossTM and STINGRAYTM LP Coronary Crossing and Re-Entry Devices.

Three Basic Techniques
Hybrid CTO Three Basic Techniques

High Technical Success/Reduced Procedure Time
>90% CTO Crossing Success
In 193 patients, CTO crossing success was > 90% with the hybrid approach.1
83 Minutes - Average Procedure Time
The hybrid approach has demonstrated lower procedure times compared to other CTO techniques.1

Hybrid Strategies for Retrograde and Antegrade Lesion Crossing Based on Anatomy, the Hybrid Registry. Talk presented at the Chronic Total Occlusion and Left Main Summit; February 21-23, 2013; New York, NY.


Putting it All Together

Four Angiographic Characteristics Dictate Strategy:
  1. Proximal cap clear or ambiguous by angio +/- IVUS
  2. Quality of distal target
  3. Lesion length < or ≥ 20 mm
  4. Suitability of “interventional” collaterals

Hybrid Algorithm for CTO PCI2
Hybrid Algorithm for CTO PCI

Brilakis ES, Grantham JA, Rinfret S, Wyman M, Burke MN, Karmpaliotis D, et al. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. J Am Coll Cardiol Intv. 2012;5(4):367-379. doi:10.1016/j.jcin.2012.02.006.