OBJECTIVES: This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. BACKGROUND: Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. METHODS: We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. RESULTS: Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of "interventional" collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = -0.093 to 0.144). CONCLUSIONS: The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach.
OBJECTIVES: This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. BACKGROUND: Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. METHODS: We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. RESULTS: Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of "interventional" collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = -0.093 to 0.144). CONCLUSIONS: The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach.
Authors: Kathleen Kearney; Ravi S Hira; Robert F Riley; Arun Kalyanasundaram; William L Lombardi Journal: Curr Atheroscler Rep Date: 2017-04 Impact factor: 5.113
Authors: J R Martinez-Parachini; A Karatasakis; D Karmpaliotis; K Alaswad; F A Jaffer; R W Yeh; M Patel; J Bahadorani; A Doing; P-K Nguyen-Trong; B A Danek; J Karacsonyi; A Alame; B V Rangan; C A Thompson; S Banerjee; E S Brilakis Journal: Diabet Med Date: 2016-11-03 Impact factor: 4.359
Authors: Mohammad Hasan Namazi; Ali Reza Serati; Hosein Vakili; Morteza Safi; Saeed Ali Pour Parsa; Habibollah Saadat; Maryam Taherkhani; Sepideh Emami; Shamseddin Pedari; Masoomeh Vatanparast; Mohammad Reza Movahed Journal: Int J Angiol Date: 2016-10-31
Authors: Georgios E Christakopoulos; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; R Michael Wyman; William Lombardi; J Aaron Grantham; David A Kandzari; Nicholas Lembo; Jeffrey W Moses; Ajay Kirtane; Manish Parikh; Philip Green; Matthew Finn; Santiago Garcia; Anthony Doing; Mitul Patel; John Bahadorani; Georgios Christopoulos; Aris Karatasakis; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: J Invasive Cardiol Date: 2016-07 Impact factor: 2.022