Conversations in Interventional Cardiology: Early Clinical Experience with CrossFAST, a Novel Microcatheter-Led Delivery System for Complex Percutaneous Coronary Intervention-Manuscript - Early Clinical Experience With CrossFAST, a Novel, Microcatheter-Led Delivery System for Complex Percutaneous Coronary Intervention

Manuscript - Early Clinical Experience With CrossFAST, a Novel, Microcatheter-Led Delivery System for Complex Percutaneous Coronary Intervention

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This original research describes early clinical experience with CrossFAST, a new microcatheter-led guide extension delivery system designed for complex percutaneous coronary intervention (PCI). Unlike first-generation guide extension catheters, which have blunt distal ends and can be difficult or risky to advance deeply, CrossFAST uses a tapered inner microcatheter that “snaps” into an outer catheter, creating a seamless, low-profile transition intended to improve deliverability and reduce dissection risk.<br /><br />The authors report four retrospective case examples in which CrossFAST was used after conventional methods failed, including standard guide extension catheters and other delivery techniques. The cases involved severe, calcified, and tortuous coronary disease in the right coronary artery, left circumflex artery, left anterior descending artery, and diagonal branch. In each case, CrossFAST could be advanced to or beyond the target lesion, enabling successful stent delivery and deployment with TIMI 3 flow and no major complications.<br /><br />The paper emphasizes the practical advantages of CrossFAST in difficult anatomy: improved pushability, safer deep intubation, and the ability to reach distal lesions without balloon-assisted tracking or repeated “inchworm” maneuvers. It also notes limitations, including the need to remove side branch wires in some situations and the current inability to deliver larger devices such as some intravascular imaging or lithotripsy systems.<br /><br />Overall, the authors conclude that CrossFAST appears promising for complex PCI, especially in calcified or tortuous vessels where conventional guide extension catheters fail, but larger studies are needed to confirm safety and efficacy compared with standard approaches.

Keywords

CrossFAST

guide extension catheter

microcatheter

complex PCI

coronary intervention

calcified lesions

tortuous vessels

stent delivery

TIMI 3 flow

deep intubation