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Mini‐STAR as bail‐out strategy for percutaneous coronary intervention of chronic total occlusion
Author(s) -
Galassi Alfredo Ruggero,
Tomasello Salvatore Davide,
Costanzo Luca,
Campisano Maria Barbara,
Barrano Giombattista,
Ueno Masafumi,
TelloMontoliu Antonio,
Tamburino Corrado
Publication year - 2012
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22998
Subject(s) - medicine , percutaneous coronary intervention , conventional pci , fluoroscopy , coronary occlusion , cardiology , revascularization , myocardial infarction , radiology
Background: Although the advancement of the equipment and the presence of innovative techniques, percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) continues to be affected by lower procedural success in comparison with non occluded vessel PCI. Objective: We describe a new technique for the treatment of coronary CTO which utilizes a new generation of polymeric wires. Methods and Result: From March 2009 to June 2010 different strategies were adopted as “bail out” after an initial attempt failed in 117 consecutive CTO lesions. Among these, conventional strategies (CS) such as parallel wire, sub‐intimal tracking and re‐entry (STAR), microchannel technique, intracoronary ultrasound guided revascularization and anchor balloon, were used in 75 cases (64.1%), while in the remaining a new technique, the “mini‐STAR,” was used (39.9%). Although no substantial differences were observed regarding the distribution of clinical features and angiographic lesions characteristics between the populations, mini‐STAR was able to achieve a higher rate of procedural success in comparison with other CS (97.6% vs. 52%, P < 0.001) with lower contrast agent use (442 ± 259 cm 3 vs. 561 ± 243 cm 3 , P = 0.01) and shorter procedural and fluoroscopy times (122 ± 61 vs. 157 ± 74 min, P = 0.009 and 60 ± 31 min vs. 75 ± 38 min, P = 0.03, respectively). No differences were observed in term of peri‐procedural complications such as procedural myocardial infarction, coronary perforations, and contrast‐induced nephropathy between mini‐STAR and CS. Conclusion: The mini‐STAR technique is a promising strategy for the treatment of CTO lesions, achieving a high procedural success rate and low occurrence of procedural adverse events. © 2011 Wiley Periodicals, Inc