Impact of subintimal plaque modification(SPM)technique on failed intervention of coronary artery chronic total occlusion

摘要

To the editor:The intervention of chronic total occlusion(CTO)of coronary artery is the last castle to be conquered in coronary intervention.1 With the development of techniques and guidewires,even in high-volume centers,the failure rate of CTO is still 10%-15%.Vo MN et al2 described a“subintimal plaque modification”(SPM)that involves use of antegrade and retrograde dissection reentry techniques to treat“balloon-un-crossable”coronary lesion in 2014.The Subintimal Tracking and Reentry(STAR)technique is not suitable for routine use during CTO percutaneous coronary intervention(PCI).SPM is also called STAR without stenting,which can be used as a bailout strategy in CTO PCI when standard crossing attempts fail.Typically,SPM technique is performed as balloon dilation of the subintimal space through the CTO segment.