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Menorah Medical Center Offers Bypass Alternative

Cardiac "Jackhammer" Destroys Arterial Plaque

June 2009

Menorah Medical Center recently purchased the new Crosser Catheter to expand the treatment options for patients suffering from blocked arteries in the legs and heart. These blockages, known as Chronic Total Occlusions (CTO), develop over time as plaque builds-up on arterial walls, ultimately closing off the artery causing leg and chest pain, and increasing the risk of heart attacks. CTOs occur in the legs and can lead to amputation and bypass surgery. CTOs are also found in one-third of patients who undergo angiographic testing for coronary artery disease.

Traditionally, CTO patients have been treated with drugs, bypass procedures, or a catheter-based, endovascular approach. Though medical management is frequently prescribed, drugs are often only a temporary fix which can help reduce the leg and chest pain but not always eliminate it. Bypass carries the risk of surgery including bleeding and infection, the potential for side effects from anesthesia as well as long hospital stays and long recovery time.

"The Crosser is a device which can open up chronically (blocked) arteries in the legs and heart. A vibrating catheter blasts its way through hard plaque deposits similar to how a jackhammer cuts through concrete," says cardiologist Daniel Scharf, Midwest Cardiology Associates. At 1mm in diameter, the catheter is a minimally-invasive endovascular devise that is delivered to the blockage within the artery using standard guide wire techniques. The doctor then energizes the catheter which delivers high-frequency vibration to pass through the blockage in the true lumen of the artery. Once the catheter tunnels throughout the occlusion, physicians can then perform standard balloon angioplasty, and coronary stent placement. For many patients, this cath-lab based, minimally invasive approach to CTO recanalization can eliminate the need for a potentially traumatic bypass procedure.

"We are excited to use the Crosser Catheter technology as a frontline therapy for chronically occluded vessels," says Dr. Scharf. I am optimistic it will allow me to quickly get through the blockage and then treat the patient with other minimally invasive techniques like angioplasty balloons and stents. For our patients, this is a favorable alternative to bypass surgery, keeping patients out of the operating room. These are old, tough blockages and the evidence is overwhelming that opening these long-standing CTOs is beneficial to avoid limb loss, while maintaining long-term survival and overall patient health."

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