Give it time to SOBER up - GITSU- a new strategy in percutaneous coronary intervention for chronic total occlusion

Area of Science:

• Cardiovascular Interventions
• Interventional Cardiology
• Vascular Biology

Background:

• Coronary chronic total occlusion (CTO) prevalence is increasing with aging populations.
• CTO percutaneous coronary interventions (PCI) face challenges like undersized stents and dissection risks.
• Limited access to intravascular imaging (IVI) is a concern in resource-limited settings.

Purpose of the Study:

• To introduce and evaluate the 'GIVE IT TIME TO SOBER UP' (GITSU) strategy for CTO-PCI.
• To assess the key attributes, outcomes, and implications of this two-session approach.
• To demonstrate achieving Thrombolysis in Myocardial Infarction (TIMI) grade 3 antegrade flow without immediate stent placement.

Main Methods:

• The GITSU strategy was applied to 53 CTO lesions over a 3-year period.
• Data collected included lesion characteristics, procedural features, and in-hospital adverse events.
• Technical and procedural success rates were evaluated for the two-session intervention.

Main Results:

• The GITSU strategy resulted in shorter lesion lengths and increased distal reference vessel diameter in the second session.
• Significant stent length savings (24.4%) and increased stent diameter (20.3%) were observed.
• High technical (92.5%) and procedural (90.6%) success rates were achieved.

Conclusions:

• Patients undergoing the GITSU strategy utilized shorter and wider stents in the second PCI session.
• This approach is anticipated to decrease rates of target lesion revascularization (TLR) and in-stent restenosis (ISR).
• The GITSU strategy offers a promising alternative for CTO-PCI, especially in challenging cases or resource-limited environments.