Cardiovascular Medicine, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, 8-1, Kita-49 Higashi-16, Higashiku, Sapporo, Japan 007-0849.
J Invasive Cardiol. 2022 Sep;34(9):E678-E682. doi: 10.25270/jic/22.00046. Epub 2022 Aug 12.
This study aimed to evaluate the clinical effectiveness and outcomes of treatment with the subintimal tracking and re-entry technique for stent-jailed side branch (SB-STAR). SB occlusion is a serious complication of percutaneous coronary intervention (PCI). However, conventional strategies may fail to recanalize the stent-jailed SB.
We retrospectively analyzed consecutive patients who underwent elective PCI and were treated with SB-STAR at the Sapporo Cardiovascular Clinic in Japan. SB was treated for severe stenosis, reduced thrombolysis in myocardial infarction flow grade, or ischemic signs after main vessel stenting. Technical success during the procedure and clinical and angiographic follow-up findings at 6 months were analyzed.
Of the 13,431 PCI procedures performed between January 2016 and June 2021, SB-STAR was performed in 10 patients. The angiographic success rate was 100%. At the 6-month follow-up, no deaths or target-vessel revascularizations had occurred. All patients underwent angiographic follow-up, and 8 of the 10 patients (80%) who underwent SB-STAR had confirmed patency.
SB-STAR can be a bailout strategy to improve the critical situation of stent-jailed SB occlusion. At 6-month follow-up, the SB-STAR had good patency as well as good clinical outcomes.
本研究旨在评估支架内夹层追踪再进入技术（SB-STAR）治疗支架内拘禁分支（SB）的临床效果和结局。SB 闭塞是经皮冠状动脉介入治疗（PCI）的严重并发症。然而，传统的策略可能无法使支架内拘禁的 SB 再通。
我们回顾性分析了在日本札幌心血管诊所接受选择性 PCI 并接受 SB-STAR 治疗的连续患者。SB 是为严重狭窄、心肌梗死溶栓血流分级降低或主血管支架置入后出现缺血迹象而治疗的。分析了手术过程中的技术成功率和 6 个月时的临床和血管造影随访结果。
在 2016 年 1 月至 2021 年 6 月期间进行的 13431 例 PCI 手术中，10 例患者接受了 SB-STAR。血管造影成功率为 100%。在 6 个月的随访中，无死亡或靶血管血运重建。所有患者均进行了血管造影随访，在接受 SB-STAR 的 10 例患者中，有 8 例（80%）患者的 SB 通畅。
SB-STAR 可以作为改善支架内拘禁 SB 闭塞危急情况的抢救策略。在 6 个月的随访中，SB-STAR 具有良好的通畅性和良好的临床结局。
