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BMJ Case Rep. 2010; 2010: bcr0520091903.
Published online 2010 November 29. doi:  10.1136/bcr.05.2009.1903
PMCID: PMC3038020
Novel treatment (new drug/intervention; established drug/procedure in new situation)

Reverse STAR for retrograde recanalisation in a chronic total coronary artery occlusion present for 21 years


Reopening chronic total occlusions (CTOs) has been shown to alleviate anginal symptoms as well improve left ventricular ejection fraction. In patients with previous coronary artery bypass grafts, management of CTOs may avoid the need for repeat surgery. A variety of techniques have been described including subintimal tracking and re-entry (STAR) and CART approaches. The anatomy and the length of time that a CTO is present can determine whether it can be reopened. The present report describes a variation on the STAR technique used to open a CTO present for 21 years.

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