Angiographic Scoring System for Predicting Successful Percutaneous Coronary Intervention of In-Stent Chronic Total Occlusion

Gong, Minglian; Peng, Hongyu; Wu, Zheng; Li, Wenzheng; Yun, Lingsong; Lv, Yuan; Zhang, Zheng; An, Tao; Zhang, Jing; Lv, Mingrui; Li, Xin; Gong, Hangyu; Mao, Yi; Liu, Jinghua

doi:10.1007/s12265-020-10090-9

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…J-Channel score had good discriminatory power for septal and non-septal collateral channel guidewire crossing success in the case of PCI by retrograde approach (respectively, an AUC of 0.744 and 0.757 in the derivation cohort) [31]. Recently developed and validated in-stent chronic total occlusion (IS-CTO) score had an exceptional predictive power (AUC 0.976) for antegrade PCI in the case of in-stent chronic total occlusion, which was significantly higher than the predictive value of J-CTO score (AUC 0.642) and PROGRESS-CTO score (AUC 0.579) [46].…”

Section: Resultsmentioning

confidence: 96%

“…All included studies had an observational design with the scores being applied retrospectively. The most investigated score in clinical studies was J-CTO [15,17,[20][21][22][23][24][25][26][27][28][29][30]34,37,38,[40][41][42][43][44][45][46] followed by PROGRESS-CTO score [18,22,24,28,37,38,41,44,46]. PCI success rate varied across studies from 48.2% [30] to 94.4% [21].…”

Section: Resultsmentioning

confidence: 99%

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Procedural Success Prediction Scoring Systems Used in Percutaneous Coronary Interventions for Chronic Total Occlusions: A Systematic Evaluation

Brinza¹,

Popa

Basarab³

et al. 2021

Healthcare

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(1) Background: Data suggest that patients with coronary chronic total occlusion (CTO) managed with percutaneous coronary intervention (PCI) could have better outcomes than those treated with optimal medical therapy alone. We aimed to systematically review dedicated scoring systems used to predict successful PCI in patients with CTO. (2) Methods: Electronic databases of MEDLINE (PubMed), Embase, and Cochrane were searched. (3) Results: 32 studies were included. We provided insights into all available predictive models of PCI success in CTO including predictive performance, validations, and comparisons between different scores and models’ limitations. Considering the differences in the population included, coronary lesions, and techniques applied across clinical studies, the most used scores displayed a modest to good predictive value, as follows: J-CTO (AUC, 0.55–0.868), PROGRESS-CTO (AUC, 0.557–0.788), CL (AUC, 0.624–0.800), CASTLE (AUC, 0.633–0.68), and KCCT (AUC, 0.703–0.776). As PCI for CTO is one of the most complex interventions, using dedicated scoring systems could ensure an adequate case selection as well as preparation for an appropriate recanalization technique in order to increase chances of successful procedure. (4) Conclusion: Clinical models appear to be valuable tools for the prediction of PCI success in CTO patients. Clinicians should be aware of the limitations of each model and should be able to correctly select the most appropriate score according to real-life case particularities such as lesion complexity and operator experience in order to maximize success and achieve the best patients’ outcomes.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Procedural Success Prediction Scoring Systems Used in Percutaneous Coronary Interventions for Chronic Total Occlusions: A Systematic Evaluation

Brinza¹,

Popa

Basarab³

et al. 2021

Healthcare

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The added value of coronary CTA in chronic total occlusion percutaneous coronary intervention: a systematic review and meta-analysis

Liang,

Bai,

Zhang

et al. 2023

Eur Radiol

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Clinical Outcome of Paclitaxel-Coated Balloon Angioplasty Versus Drug-Eluting Stent Implantation for the Treatment of Coronary Drug-Eluting Stent In-Stent Chronic Total Occlusion

Zhang

Wang

et al. 2022

Cardiovasc Drugs Ther

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Aims In-stent chronic total occlusion (IS-CTO) represents a unique challenge for percutaneous coronary intervention. Whether the optimal treatment for IS-CTO is angioplasty with paclitaxel-coated balloons (PCBs) or repeat stenting with drug-eluting stents (DESs) is unclear. We aimed to evaluate the long-term clinical outcome of PCB angioplasty and DES repeat stenting for DES IS-CTO. Methods We retrospectively included patients with DES IS-CTO who underwent successful PCB angioplasty or DES repeat stenting from January 2016 to December 2019. The primary endpoints were major adverse cardiac events (MACEs), including cardiac death, myocardial infarction, and target lesion revascularization (TLR). Cox proportional hazards model was performed to compare the risk of MACEs between PCB angioplasty and DES repeat stenting, and to further explore the prognostic factors of patients with DES IS-CTO. Results A total of 214 patients with DES IS-CTO were enrolled: 78 patients (36.4%) treated with PCB and 136 patients (63.6%) treated with DES respectively. The median follow-up was 1160 days, and MACEs were observed in 28.2% of patients with PCB angioplasty versus 26.5% of patients with DES repeat stenting (P = 0.784), mainly driven by TLR (21.8% vs. 19.9%, P = 0.735). There was no significant difference in the risk of MACEs between the PCB group and the DES group (hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.64–2.46, P = 0.512). Multivariate Cox analysis revealed that chronic kidney disease and ≥ 3 stent layers in the lesion were independent predictors of MACEs, while switching to another antiproliferative drug was an independent protective factor (all P < 0.05). Conclusions PCB angioplasty was an effective alternative treatment strategy for DES IS-CTO, which had similar long-term outcomes to DES repeat stenting in contemporary practice, but both were accompanied by a high rate of long-term MACEs. Improving the poor prognosis of patients with DES IS-CTO remains a challenge.

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Angiographic Scoring System for Predicting Successful Percutaneous Coronary Intervention of In-Stent Chronic Total Occlusion

Cited by 6 publications

References 24 publications

Procedural Success Prediction Scoring Systems Used in Percutaneous Coronary Interventions for Chronic Total Occlusions: A Systematic Evaluation

Procedural Success Prediction Scoring Systems Used in Percutaneous Coronary Interventions for Chronic Total Occlusions: A Systematic Evaluation

The added value of coronary CTA in chronic total occlusion percutaneous coronary intervention: a systematic review and meta-analysis

Clinical Outcome of Paclitaxel-Coated Balloon Angioplasty Versus Drug-Eluting Stent Implantation for the Treatment of Coronary Drug-Eluting Stent In-Stent Chronic Total Occlusion

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