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
- Authors
- Yu, Cheol-Woong; Lee, Hyun-Jong; Suh, Jon; Lee, Nae-Hee; Park, Sang-Min; Park, Taek Kyu; Yang, Jeong Hoon; Bin Song, Young; Hahn, Joo-Yong; Choi, Seung Hyuk; Gwon, Hyeon-Cheol; Lee, Sang-Hoon; Choe, Yeon Hyeon; Kim, Sung Mok; Choi, Jin-Ho
- Issue Date
- 4월-2017
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- angiography; computed tomographic angiography; percutaneous coronary intervention; probability; sensitivity and specificity
- Citation
- CIRCULATION-CARDIOVASCULAR IMAGING, v.10, no.4
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION-CARDIOVASCULAR IMAGING
- Volume
- 10
- Number
- 4
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/84071
- DOI
- 10.1161/CIRCIMAGING.116.005800
- ISSN
- 1941-9651
- Abstract
- 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.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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