Journal of Internal Medicine Concepts & Practice >

2021 , Vol. 16 >Issue 04: 230 - 233

DOI: https://doi.org/10.16138/j.1673-6087.2021.04.002

Original article

Clinical effect of subintimal stent implantation in the patients with chronic total occlusion in coronary artery

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  • Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2021-03-29

  Online published: 2022-07-25

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Abstract

Objective To evaluate clinical effect of subintimal stent implantation in the patients with chronic total occlusion(CTO) in coronary artery. Methods From January 2016 to January 2019, 73 patients with CTO in coronary artery who underwent coronary stent implantation successfully in our hospital were selected as the research objects. Intravascular ultrasound(IVUS) confirmed that a segment of the stent was in the false lumen (subintimal), but the proximal and distal parts of the stent were in the true lumen. The clinical and biochemical indexes of all patients were recorded in details. The clinical characteristics, major adverse cardiac events (MACE) (including death, angina recurrence, in-stent restenosis, and revascularization due to myocardial ischemia) during hospitalization and one-year follow-up were carefully noted. Results During one-year follow-up period, there were no death cases, 2 cases of myocardial infarction, 9 cases of angina recurrence, and the incidence of MACE was 15%. In addition, 13(18%) patients had in-stent restenosis, and 11 (15%) patients underwent revascularization due to myocardial ischemia again. Conclusions The subintimal stent implantation is feasible and effective approach for chronic coronary artery occlusion.

Key words： Chronic total occlusion; Subintimal; Stent; Major adverse cardiac events

Cite this article

HU Jian, YANG Zhenkun, YAN Xiaoxiang, NI Jun, DING Fenghua . Clinical effect of subintimal stent implantation in the patients with chronic total occlusion in coronary artery[J]. Journal of Internal Medicine Concepts & Practice, 2021 , 16(04) : 230 -233 . DOI: 10.16138/j.1673-6087.2021.04.002

References

[1] Koelbl CO, Nedeljkovic ZS, Jacobs AK. Coronary chronic total occlusion(CTO)[J]. Rev Cardiovasc Med, 2018, 19(1): 33-39.
[2] Galassi AR, Brilakis ES, Boukhris M, et al. Appropriateness of percutaneous revascularization of coronary chronic total occlusions: an overview[J]. Eur Heart J, 2016, 37(35): 2692-2700.
[3] Kandzari DE, Grantham JA, Karmpaliotis D, et al. Safety and efficacy of dedicated guidewire and microcatheter technology for chronic total coronary occlusion revascularization: principal results of the Asahi Intecc Chronic Total Occlusion Study[J]. Coron Artery Dis, 2018, 29(8): 618-623.
[4] Wu EB, Tsuchikane E, Lo S, et al. Chronic total occlusion wiring: a state-of-the-art guide from the Asia Pacific Chronic Total Occlusion Club[J]. Heart Lung Circ, 2019, 28(10): 1490-1500.
[5] Tanabe M, Kodama K, Asada K, et al. Lesion characteristics and procedural outcomes of re-attempted percutaneous coronary interventions for chronic total occlusion[J]. Heart Vessels, 2018, 33(6): 573-582.
[6] Azzalini L, Carlino M, Brilakis ES, et al. Subadventitial techniques for chronic total occlusion percutaneous coronary intervention: the concept of “vessel architecture”[J]. Catheter Cardiovasc Interv, 2018, 91(4): 725-734.
[7] Galassi AR, Sianos G, Werner GS, et al. Retrograde recanalization of chronic total occlusions in Europe: procedural, in-hospital, and long-term outcomes from the multicenter ERCTO registry[J]. J Am Coll Cardiol, 2015, 65(22): 2388-2400.
[8] Sakamoto A, Torii S, Jinnouchi H, et al. Histopathologic and physiologic effect of overlapping vs single coronary stents: impact of stent evolution[J]. Expert Rev Med Devices, 2018, 15(9): 665-682.
[9] Shlofmitz E, Iantorno M, Waksman R. Restenosis of drug-eluting stents[J]. Circ Cardiovasc Interv, 2019, 12(8): e007023.
[10] Carlino M, Figini F, Ruparelia N, et al. Predictors of restenosis following contemporary subintimal tracking and reentry technique: the importance of final TIMI flow grade[J]. Catheter Cardiovasc Interv, 2016, 87(5): 884-892.
[11] Azzalini L, Karatasakis A, Spratt JC, et al. Subadventitial stenting around occluded stents[J]. Catheter Cardiovasc Interv, 2018, 92(3): 466-476.
[12] Tadano Y, Kotani JI, Kashima Y, et al. Predictors of clinical outcomes after coronary implantation of bioresorbable polymer sirolimus-eluting ultimaster stents in all-comers[J]. Catheter Cardiovasc Interv, 2019, 94(1): 91-97.
[13] Yerasi C, Case BC, Forrestal BJ, et al. Drug-coated balloon for de novo coronary artery disease[J]. J Am Coll Cardiol, 2020, 75(9): 1061-1073.
[14] Rodriguez-Paz E, Heuser R. Staged CTO PCI: the investment that pays dividends[J]. Catheter Cardiovasc Interv, 2020, 96(5): 1036.
[15] Mashayekhi K, Büttner HJ. Chronic coronary occlusions : when and how should revascularization be performed?[J]. Herz, 2016, 41(7): 585-590.
[16] Xenogiannis I, Choi JW, Alaswad K, et al. Outcomes of subintimal plaque modification in chronic total occlusion percutaneous coronary intervention[J]. Catheter Cardiovasc Interv, 2020, 96(5): 1029-1035.
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