# Catheter for Complex Percutaneous Coronary Intervention

> **NIH NIH R44** · CROSSLINER INC · 2024 · $994,964

## Abstract

ABSTRACT
Nearly 1 million percutaneous coronary interventions (PCIs) are performed each year in the US. Approximately
70% of these cases are considered complex and require the treatment of calcified lesions, tortuous vessels, and
multi-vessel disease, often with total or sub-totally occluded lesions. Many operators avoid these more complex
cases due to the lack of guide catheter support required to effectively deliver coronary stents and other
interventional devices. To overcome this limitation, guide extension catheters (GEC) have been developed to
help deliver stents in these challenging anatomies. However, GECs are utilized in only 18% of all coronary
interventions, mostly as a bailout option, because of their inability to access more distal tortuous lesions in 28%
of cases which prevents stent delivery. Blunt ended tubular GECs also have serious safety issues with coronary
artery dissection and/or plaque or thrombus embolization. Such limited utilization demonstrates that a significant
volume of patients are not treated effectively. Hence, CrossLiner Inc. has developed a novel multi-functional
GEC that combines the requirement for deeper catheter intubation with a microcatheter leading tip, and pre-
dilatation balloon on the leading element, to allow safe crossing of severe lesions in tortuous coronary vessels,
with balloon pre-dilatation, followed by crossing the lesion with the guide extension and then seamless stent
delivery. The combination of a GEC with a seamless transition to a microcatheter-balloon provides the capability
for easier and safer stent delivery, which can be unsheathed at the lesion as opposed to being delivered from a
poorly supported proximal location. This approach enabled by the CrossLiner GEC will substantially improve PCI
in patients with complex lesions while reducing risks, procedural duration, radiation/contrast exposure, stent
dislodgement, coronary dissection and perforation that occur with current GECs. Data from Phase II bench
verification studies demonstrates safety and performance against ISO standards while conforming to design
specifications. Formative usability evaluation supports the ease of use and safety, as validated on bench and in
vivo which demonstrated a 100% technical success rate, 40% reduction in time to treat, 43% reduction in
radiation dose, and 2-3x increase in coronary intubation depth compared to current market leading GECs. These
results, value proposition and likely market adoption were corroborated by interviews with 67 interventional
cardiologists where over 70% expected improved clinical outcomes and 94% indicated they would use the
CrossLiner GEC, rather than a conventional GEC. The company is now ready for final verification and process
validation in conjunction with regulatory submission and clearance. Successful execution of these Phase IIB
studies will position the CrossLiner GEC system for full commercialization of a highly innovative approach to
improve the treatment for compl...

## Key facts

- **NIH application ID:** 10797845
- **Project number:** 2R44HL152835-04
- **Recipient organization:** CROSSLINER INC
- **Principal Investigator:** Tim Alexander Fischell
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $994,964
- **Award type:** 2
- **Project period:** 2020-07-20 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10797845

## Citation

> US National Institutes of Health, RePORTER application 10797845, Catheter for Complex Percutaneous Coronary Intervention (2R44HL152835-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10797845. Licensed CC0.

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