ABSTRACT
The Frontrunner catheter was originally designed to open chronic total occlusions (CTOs) of coronary and peripheral arteries refractory to guidewire recanalization. The device works by creating blunt microdissection, taking advantage of the increased elastic properties of the arterial wall compared with plaque. The company decided to suspend marketing the coronary Frontrunner X39 catheter indefinitely. However, the Frontrunner XP Peripheral Catheter and Outback LTD Reentry Catheter are available for use. The original Frontrunner device for coronary artery application was 4.5 Fr in size. This size mandated utilization of an 8 Fr guiding catheter for contrast injections in order to safely guide Frontrunner advancement through the artery to the occlusion. A new Frontrunner platform was developed for use in CTOs of peripheral arteries. The Frontrunner XP Peripheral CTO Catheter is 0.039 inch distal tip size. In summary, the Frontrunner X39 coronary catheter is a device useful to open approximately 50–60% of CTO cases refractory to guidewire techniques.
