Treating chronic total occlusions using subintimal tracking and reentry: the STAR technique

摘要: Successful recanalization of coronary total occlusions (CTOs) remains an area where improvements are needed. We propose approach similar to the one utilized in treating some peripheral artery and aimed create a subintimal dissection with distal reentry. A 0.014' hydrophilic wire J-configuration is for this purpose. applied technique CTO native coronaries 31 patients previous attempts failed 21 them (67%). The right (RCA) was index vessel 87% patients. Recanalization most branches achieved patients; patency at least major branch 9 Drug-eluting stents (DESs) were implanted 53% Three had intraprocedural perforation without consequences. Five (16%) in-hospital non-Q-wave myocardial infarction. No other adverse events occurred mean follow-up 5.1 +/- 3.7 months except noncardiac death. Angiographic performed (67%) developed restenosis. Reintervention on target 11 (52%). Complete success procedure originally obtained 8 10 who did not develop restenosis DESs implanted. This appears promising recanalize difficult occlusions, particularly ones localize RCA, which has important side located distally.