Early vs Late Staged PCI After Subintimal Tracking and Re-Entry for Chronic Total Occlusions: A Randomized Trial.

The optimal timing for staged stenting is unknown.

分期支架植入的最佳时机尚不明确。

In this study, the authors sought to evaluate the timing of staged PCI after STAR by randomizing to an earlier (5-7 weeks) or later (12-14 weeks) timeframe.

在这项研究中，作者试图评估在STAR后分期PCI的时机，通过随机分配到较早（5-7周）或较晚（12-14周）的时间框架。

Methods

Patients undergoing CTO PCI with the use of STAR (n = 150) were randomized at 6 centers to early or late staged PCI.

在使用STAR进行CTO PCI的患者（n = 150）被随机分配到6个中心进行早期或晚期分期PCI。

The primary endpoint was partial technical success of the staged procedure, defined as TIMI flow grade 2-3 with <30% residual stenosis into at least 1 ≥2.5 mm distal branch.

主要终点是分期手术的部分技术成功，定义为至少有一个≥2.5毫米的远端分支的TIMI血流分级为2-3级，且残余狭窄小于30%。

Study outcomes were compared between groups with the use of chi-square and Fisher exact tests.

使用卡方检验和Fisher精确检验比较了两组之间的研究结果。

Results

Seventy-three patients were randomized to the early group and 77 to the late group.

73名患者被随机分配到早期组，77名患者被分配到晚期组。

The mean Japanese-CTO score was 2.9 ± 1.1.

平均日本-CTO评分为2.9±1.1。

Differences in the primary endpoint between the early group and the late group did not reach statistical significance (83.6% vs 71.4%; P = 0.08).

早期组与晚期组在主要终点指标上的差异未达到统计学意义（83.6% 对比 71.4%；P = 0.08）。

TIMI flow grade 2-3 in the target vessel at the start of staged procedure was higher in the early group (64.4% vs 44.2%; P = 0.012; P = 0.048 after adjustment).

在分阶段手术开始时，早期组靶血管的TIMI血流2-3级更高（64.4% 对比 44.2%；P = 0.012；调整后P = 0.048）。

Conclusions

Among patients undergoing STAR with deferred stenting after an unsuccessful index CTO PCI attempt, the partial technical success rate of staged procedures was high.

在接受CTO PCI尝试失败后进行STAR并推迟支架植入的患者中，分期手术的部分技术成功率很高。

Although vessel patency was higher at the start of early staged procedures, there were no statistically significant differences for partial technical success of the staged procedure with early or late treatment.

尽管早期分期手术开始时血管通畅性更高，但早期或晚期治疗的分期手术部分技术成功率没有统计学上的显著差异。

(STAR and Deferred Stenting Study [STAR]; NCT05089864).

(STAR和延期支架植入研究[STAR]; NCT05089864).