Document Detail

Subintimal tracking and re-entry technique with contrast guidance: a safer approach.
MedLine Citation:
PMID:  19006242     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To assess the procedural and clinical outcomes from a modified subintimal tracking and re-entry (STAR) procedure performed using contrast guidance. BACKGROUND: Previous data showed that recanalizing a chronic total occlusion (CTO) with the STAR technique was possible. However, this technique was considered difficult and therefore has only been adopted by a limited number of experienced operators. METHODS: Patients (n = 68) with a CTO of a native coronary artery treated by a single operator with this technique were included. RESULTS: The right coronary artery was involved in 79.4%, the morphology was blunt in 77.9%, and CTO length was longer than 20 mm in 67.6%. Angiographic success rate was 80.9% with a 70.6% rate of complete recanalization. Stent implantation was performed in 82.3% of cases, with drug-eluting stents (DES) implanted in the majority (92.7%). Procedural complications occurred in 10.3% of cases. There were no episodes of myocardial infarction during follow-up, with 1 case (1.5%) of cardiac death. There were no cases of definite or probable stent thrombosis, and there was 1 (1.5%) possible stent thrombosis. The overall rate of in-segment binary restenosis was 44.7%, and target lesion revascularization (TLR) was performed in 25% of lesions. The rate of TLR in lesions treated with DES was 29.4% and in those treated with bare-metal stents was 50%. CONCLUSION: The contrast-guided STAR technique appears to be feasible and relatively safe. However, this procedure is limited by a high rate of restenosis even with DES, and a second procedure may be necessary to obtain a definitive result.
Mauro Carlino; Cosmo Godino; Azeem Latib; Jeffrey W Moses; Antonio Colombo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  72     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  790-6     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  instrumentation,  methods*
Chronic Disease
Clinical Competence
Contrast Media / diagnostic use*
Coronary Angiography*
Coronary Occlusion / radiography*,  therapy*
Coronary Restenosis / etiology
Drug-Eluting Stents
Feasibility Studies
Middle Aged
Patient Selection
Prosthesis Design
Radiography, Interventional*
Thrombosis / etiology
Treatment Outcome
Reg. No./Substance:
0/Contrast Media; 0/Metals
Comment In:
Catheter Cardiovasc Interv. 2008 Nov 15;72(6):797-8   [PMID:  19009626 ]
Erratum In:
Catheter Cardiovasc Interv. 2009 Jan 1;73(1):127

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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