Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention

JACC-CARDIOVASCULAR IMAGING

卷:11

Article

Fujino, Akiko¹  Otsuji, Satoru¹  Hasegawa, Katsuyuki¹  Arita, Toyohiro¹  Takiuchi, Shin¹  Fujii, Kenichi¹  Yabuki, Masanori¹  Ibuki, Motoaki¹  Nagayama, Shinya¹  Ishibuchi, Kasumi¹  Kashiyama, Toshikazu¹  Ishii, Rui¹  Tamaru, Hiroto¹  Yamamoto, Wataru¹  Hara, Masahiko²  Higashino, Yorihiko¹ 

[1] Higashi Takarazuka Satoh Hosp, Dept Cardiol, 2-1 Nagaocho, Takarazuka, Hyogo 6650873, Japan

[2] Osaka Univ, Grad Sch Med, Dept Clin Epidemiol & Biostat, Suita, Osaka, Japan

关键词: chronic total occlusion;    computed tomography;    coronary angiography;    percutaneous coronary intervention;   

DOI  :  10.1016/j.jcmg.2017.01.028

来源: Elsevier

【 摘 要 】

OBJECTIVES The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. BACKGROUND Coronary CTA can be used to assess the morphology of CTO lesions. METHODS We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI. The J-CTO (Multicenter CTO Registry of Japan) score (the sum of the following 5 binary parameters: blunt proximal cap, calcification, bending >45 degrees, and length of occluded segment >20 mm plus previously failed PCI attempt) was calculated using both CTA and conventional coronary angiography and compared. RESULTS The median patient age was 69 years (interquartile range: 62 to 75 years), 82.4% were male, and a retrograde approach was attempted in 72 (33.0%) cases. The procedural success rate of the CTO-PCI procedures was 82.6%, and 29.4% of cases achieved 30-min wire crossing. The areas under the curve of the CTA-derived J-CTO score for predicting procedural success and 30-min wire crossing were significantly greater than those derived from conventional angiography (0.855 vs. 0.698; p < 0.001 for procedural success and 0.812 vs. 0.692; p < 0.001, for 30-min wire crossing). In addition, the areas under the curve of CTA-derived evaluations of calcification, bending, and occlusion length were significantly higher than those of derived from angiography for predicting procedural success. CONCLUSIONS The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography. (c) 2018 by the American College of Cardiology Foundation.

【 授权许可】

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