Intravascular ultrasound-guided STAR 2.0: A new technique for chronic total occlusion recanalization

The use of the subintimal space has allowed a massive advancement in the field of chronic total occlusion percutaneous coronary intervention (PCI). The STAR technique is the first of subintimal techniques. Despite a high acute success rate, follow-up results showed unfavorable outcomes with half of the treated patients showing restenosis/reocclusion at 6 months. We present three cases in which a modification of the STAR technique guided by intravascular ultrasound (IVUS), namely the STAR 2.0, was used as a bailout for successful PCI of chronic total occlusions.