Korean Journal of Radiology

  • 제22권5호
  • /
  • Pages.697-705
  • /
  • 2021
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

  • Jiahui Li (Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease) ;
  • Rui Wang (Department of Radiology, Beijing Anzhen Hospital, Capital Medical University) ;
  • Christian Tesche (Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina) ;
  • U. Joseph Schoepf (Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina) ;
  • Jonathan T. Pannell (Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina) ;
  • Yi He (Department of Radiology, Beijing Anzhen Hospital, Capital Medical University) ;
  • Rongchong Huang (Department of Cardiology, Beijing Friendship Hospital, Capital Medical University) ;
  • Yalei Chen (Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease) ;
  • Jianan Li (Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease) ;
  • Xiantao Song (Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease)
  • 투고 : 2020.06.01
  • 심사 : 2020.08.16
  • 발행 : 2021.05.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

키워드

과제정보

The authors thank doctors from Cardiology and Radiology Departments for assistance in data collection.

참고문헌

  1. Brilakis ES, Banerjee S, Karmpaliotis D, Lombardi WL, Tsai TT, Shunk KA, et al. Procedural outcomes of chronic total occlusion percutaneous coronary intervention: a report from the NCDR (National Cardiovascular Data Registry). JACC Cardiovasc Interv 2015;8:245-253
  2. Grantham JA, Marso SP, Spertus J, House J, Holmes DR Jr, Rutherford BD. Chronic total occlusion angioplasty in the United States. JACC Cardiovasc Interv 2009;2:479-486
  3. Joyal D, Afilalo J, Rinfret S. Effectiveness of recanalization of chronic total occlusions: a systematic review and metaanalysis. Am Heart J 2010;160:179-187
  4. Staruch AD, Opolski MP, Slomka PJ, Staruch M, Kepka C, Witkowski A, et al. Automated quantitative plaque analysis for discrimination of coronary chronic total occlusion and subtotal occlusion in computed tomography angiography. J Thorac Imaging 2016;31:367-372
  5. Maeremans J, Walsh S, Knaapen P, Spratt JC, Avran A, Hanratty CG, et al. The hybrid algorithm for treating chronic total occlusions in Europe: the RECHARGE registry. J Am Coll Cardiol 2016;68:1958-1970
  6. Christopoulos G, Wyman RM, Alaswad K, Karmpaliotis D, Lombardi W, Grantham JA, et al. Clinical utility of the Japanchronic total occlusion score in coronary chronic total occlusion interventions: results from a multicenter registry. Circ Cardiovasc Interv 2015;8:e002171
  7. Morino Y, Abe M, Morimoto T, Kimura T, Hayashi Y, Muramatsu T, et al. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: the J-CTO (Multicenter CTO Registry in Japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc Interv 2011;4:213-221
  8. Alessandrino G, Chevalier B, Lefevre T, Sanguineti F, Garot P, Unterseeh T, et al. A clinical and angiographic scoring system to predict the probability of successful firstattempt percutaneous coronary intervention in patients with total chronic coronary occlusion. JACC Cardiovasc Interv 2015;8:1540-1548
  9. Christopoulos G, Kandzari DE, Yeh RW, Jaffer FA, Karmpaliotis D, Wyman MR, et al. Development and validation of a novel scoring system for predicting technical success of chronic total occlusion percutaneous coronary interventions: the PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) score. JACC Cardiovasc Interv 2016;9:1-9
  10. Maeremans J, Spratt JC, Knaapen P, Walsh S, Agostoni P, Wilson W, et al. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: the RECHARGE score. Catheter Cardiovasc Interv 2018;91:192-202
  11. Magro M, Schultz C, Simsek C, Garcia-Garcia HM, Regar E, Nieman K, et al. Computed tomography as a tool for percutaneous coronary intervention of chronic total occlusions. EuroIntervention 2010;6 Suppl G:G123-G131
  12. Fujino A, Otsuji S, Hasegawa K, Arita T, Takiuchi S, Fujii K, et al. Accuracy of J-CTO score derived from computed tomography versus angiography to predict successful percutaneous coronary intervention. JACC Cardiovasc Imaging 2018;11:209-217
  13. Werner GS, Hecht H, Stone GW. Utility of CT angiography to guide coronary intervention of CTO. JACC Cardiovasc Imaging 2015;8:814-816
  14. Opolski MP, Achenbach S, Schuhback A, Rolf A, Mollmann H, Nef H, et al. Coronary computed tomographic prediction rule for time-efficient guidewire crossing through chronic total occlusion: insights from the CT-RECTOR multicenter registry (Computed Tomography Registry of Chronic Total Occlusion Revascularization). JACC Cardiovasc Interv 2015;8:257-267
  15. Opolski MP, Achenbach S. CT angiography for revascularization of CTO: crossing the borders of diagnosis and treatment. JACC Cardiovasc Imaging 2015;8:846-858
  16. Luo C, Huang M, Li J, Liang C, Zhang Q, Liu H, et al. Predictors of interventional success of antegrade PCI for CTO. JACC Cardiovasc Imaging 2015;8:804-813
  17. Rolf A, Werner GS, Schuhback A, Rixe J, Mollmann H, Nef HM, et al. Preprocedural coronary CT angiography significantly improves success rates of PCI for chronic total occlusion. Int J Cardiovasc Imaging 2013;29:1819-1827
  18. Opolski MP. Cardiac computed tomography for planning revascularization procedures. J Thorac Imaging 2018;33:35-54
  19. Yu CW, Lee HJ, Suh J, Lee NH, Park SM, Park TK, et al. 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. Circ Cardiovasc Imaging 2017;10:e005800
  20. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988;44:837-845
  21. Patel VG, Brayton KM, Tamayo A, Mogabgab O, Michael TT, Lo N, et al. Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 18,061 patients from 65 studies. JACC Cardiovasc Interv 2013;6:128-136
  22. Li Y, Xu N, Zhang J, Li M, Lu Z, Wei M, et al. Procedural success of CTO recanalization: comparison of the J-CTO score determined by coronary CT angiography to invasive angiography. J Cardiovasc Comput Tomogr 2015;9:578-584
  23. Tan Y, Zhou J, Zhang W, Zhou Y, Du L, Tian F, et al. Comparison of CT-RECTOR and J-CTO scores to predict chronic total occlusion difficulty for percutaneous coronary intervention. Int J Cardiol 2017;235:169-175