{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:50:21Z","timestamp":1787237421141,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Antegrade dissection reentry with Stingray device (Boston Scientific, Marlborough, MA) accounts for 20\u201334% of the chronic total occlusion (CTO) cases in the various hybrid operators' CTO registries and is an important component of CTO crossing algorithms. The Stingray device can facilitate antegrade dissection and reentry, however its use is low outside North America and Europe. The Asia Pacific CTO Club along with three experience Stingray operators from the US, Europe and India, created an algorithm guiding use of the CrossBoss and Stingray catheter. This APCTO Stingray algorithm defines when to use the CrossBoss and Stingray device recommending a reduction in CrossBoss use except for in\u2010stent restenosis lesions and immediate transition from knuckle wiring to the Stingray device. When antegrade wiring fails, choice of Stingray\u2010facilitated reentry versus parallel wiring depends on operator experience, device availability, cost concerns, and anatomical factors. When the antegrade wire enters the subintimal space, we recommend using a rotational microcatheter to produce a channel and deliver the Stingray balloon\u2014so called the \u201cbougie technique.\u201d We recommend early switch to Stingray rather than persisting with single wire redirection or parallel wire. We recommend choosing a suitable reentry zone based on preprocedural computer tomography or angiogram, routine use of stick and swap, routine use of Subintimal TRAnscatheter Withdrawal (STRAW) through the Stingray balloon, and the multi stick and swap technique. We believe these techniques and algorithm can facilitate incorporation of the Stingray balloon into the practice of CTO interventionists globally.<\/jats:p>","DOI":"10.1002\/ccd.28607","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T05:21:27Z","timestamp":1574745687000},"page":"1423-1433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Advances in CrossBoss\/Stingray use in antegrade dissection reentry from the Asia Pacific Chronic Total Occlusion Club"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1018-8866","authenticated-orcid":false,"given":"Eugene B.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics Prince of Wales Hospital, Chinese University Hong Kong  Shatin Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-9701","authenticated-orcid":false,"given":"Emmanouil S.","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Liverpool Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Kalyanasundaram","sequence":"additional","affiliation":[{"name":"Department of Cardiology Promed Hospital  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kambis","family":"Mashayekhi","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Angiology II University Heart Center Freiburg\u2014Bad Krozingen  Bad Krozingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5278-3540","authenticated-orcid":false,"given":"Hsien\u2010Li","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo\u2010Teik","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Heart Centre  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Cardiology Shanghai Zhongshan Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u2010Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Guangdong General Hospital  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Fuwai Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5952","authenticated-orcid":false,"given":"Seung\u2010Whan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Centre  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Harding","sequence":"additional","affiliation":[{"name":"Department of Cardiology Wellington Hospital  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuo","family":"Tsuchikane","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Toyohashi Heart Centre  Toyohashi Aichi 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