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Published on: May 14, 2013
Subintimal Plaque Modification and Subintimal Dissection and Reentry: Strategies to Turn Failure into Success
Michael Megaly1, Ashish Pershad1
1University of Arizona College of Medicine Phoenix, 475 North 5th Street, Phoenix, AZ 85004, USA.
Abstract:
The success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) depends on the execution of bailout strategies, like subintimal dissection and reentry (STAR) and subintimal plaque modification (SPM). These are invaluable when traditional techniques fail. SPM is a modification of the STAR technique in which angioplasty is performed of the occluded segment without true lumen access in the distal vessel. Available data on SPM has shown favorable outcomes with a greater than 90% success rate when the failed CTO is reattempted in 8-12 weeks after SPM has been performed. Future studies are needed to better assess its role.
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