Coronary Computed Tomography Angiography Predicts Guidewire Crossing and Success of Percutaneous Intervention for Chronic Total Occlusion: Korean Multicenter CTO CT Registry Score as a Tool for Assessing Difficulty in Chronic Total Occlusion Percutaneous Coronary Intervention.
In: Circulation. Cardiovascular imaging, Jg. 10 (2017-04-01), Heft 4
Online
academicJournal
Zugriff:
Background: We developed a model that predicts difficulty of percutaneous coronary intervention for coronary chronic total occlusion (CTO) using coronary computed tomographic angiography.
Methods and Results: A total of 684 CTO lesions with preprocedural computed tomographic angiography were enrolled from 4 centers. Data were randomly divided into derivation and validation datasets at 2:1 ratio. The end point was successful guidewire crossing ≤30 minutes, which was met in 50%. The KCCT (Korean Multicenter CTO CT Registry) score was developed based on independent predictors identified by multivariable analysis, which were proximal blunt entry, proximal side branch, bending, occlusion length ≥15 mm, severe calcification, whole luminal calcification, reattempt, and ≥12 months or unknown duration of occlusion. The KCCT score was compared with the other prediction scores, including angiography-based J-CTO, PROGRESS-CTO, CL-score, and CT-based CT-RECTOR. The probability of guidewire crossing ≤30 minutes declined consistently from 100% to 0% according to the KCCT score ( P <0.01, all). The KCCT score showed higher discriminative performance compared with the other scoring systems (c-statistics=0.78 versus 0.65-0.72, P <0.001, all). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of a KCCT score of <4 for guidewire crossing ≤30 minutes was 70%, 68%, 72%, 73%, and 70%, respectively. The KCCT score also showed consistent results with procedural success ( P <0.05, all). These results could be reproduced in validation data set ( P <0.05, all).
Conclusions: KCCT scoring could predict successful guidewire crossing ≤30 minutes and also procedural success. KCCT scoring may enable noninvasive grading difficulty of CTO percutaneous coronary intervention.
(© 2017 American Heart Association, Inc.)
Titel: |
Coronary Computed Tomography Angiography Predicts Guidewire Crossing and Success of Percutaneous Intervention for Chronic Total Occlusion: Korean Multicenter CTO CT Registry Score as a Tool for Assessing Difficulty in Chronic Total Occlusion Percutaneous Coronary Intervention.
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Autor/in / Beteiligte Person: | Yu, CW ; Lee, HJ ; Suh, J ; Lee, NH ; Park, SM ; Park, TK ; Yang, JH ; Song, YB ; Hahn, JY ; Choi, SH ; Gwon, HC ; Lee, SH ; Choe, YH ; Kim, SM ; Choi, JH |
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Zeitschrift: | Circulation. Cardiovascular imaging, Jg. 10 (2017-04-01), Heft 4 |
Veröffentlichung: | Hagerstown, MD Lippincott Williams & Wilkins, 2017 |
Medientyp: | academicJournal |
ISSN: | 1942-0080 (electronic) |
DOI: | 10.1161/CIRCIMAGING.116.005800 |
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