Alejandro González Veliz: SCO May Be One of the Most Misunderstood Areas in Interventional Cardiology
Alejandro González Veliz, Interventional Cardiologist at Institute of Cardiology and Cardiovascular Surgery, shared a post on LinkedIn about recent article by Michaella Alexandrou et al., published in European Heart Journal, adding:
“Subacute coronary occlusion (SCO) may be one of the most misunderstood areas in interventional cardiology.
These patients exist in the space between acute STEMI and chronic total occlusion:not unstable enough for automatic emergent PCI…but not truly ‘stable’ either.
The challenge?
The myocardium may still be viable.
Ischemia may still be ongoing.
But procedural risks also increase significantly.
This is where physiology becomes more important than the clock.
Modern decision-making increasingly depends on:
- Myocardial viability
- Ongoing ischemia
- Residual coronary flow
- Hemodynamic stability
- Individualized risk-benefit assessment
The classic binary model:
‘open immediately’ vs ‘treat medically’ is no longer enough.
Subacute coronary occlusions represent the true grey zone of coronary intervention.”
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