Procedural success of CTO recanalization: Comparison of the J-CTO score determined by coronary CT angiography to invasive angiography
Procedural success of CTO recanalization: Comparison of the J-CTO score determined by coronary CT angiography to invasive angiography
复制标题
DOI：
10.1016/j.jcct.2015.07.005
复制
发表时间：
2015-11-01
影响因子：
5.4
通讯作者：
Zhang, Yang
中科院分区：
文献类型：
--
作者：
Li, Yuehua;Xu, Nan;Zhang, Yang
目的：J-CTO评分基于侵入性血管造影，结合了慢性完全冠状动脉闭塞（CTO）的几个参数，并已被充分确立用于预测经皮再通成功的可能性。本研究的目的是评估和验证来自冠状动脉计算机断层扫描血管造影术（冠状动脉CTA）的J-CTOCT评分。方法：2011年4月至2014年12月期间，回顾性纳入159例连续患者。所有患者均在侵入性血管造影中至少有一次CTO，在侵入性血管造影后不超过一周的时间间隔内进行了冠状动脉CTA，并在冠状动脉CTA后尝试了经皮冠状动脉介入治疗（PCI）。与血管造影J-CTO评分平行，J-CTOCT评分通过对钝性血管残端、弯曲> 45、闭塞长度>= 20 mm、存在钙覆盖闭塞内任何血管横截面的> 50%，或先前PCI尝试失败。a.两个分数进行了比较，就其预测成功recanalization.Results的能力：共171 CTO病变进行了分析。J-CTOCT评分计算的观察者内（k = 0.814，p < 0.001）和观察者间一致性（k = 0.771，p < 0.001）接近。冠状动脉CTA测量的平均闭塞长度明显短于有创血管造影（27.6 +/- 14.8 mm vs. 37.2 +/- 18.8 mm，p < 0.001）。J-CTOCT评分（平均值：1.9 ± 1.4）与血管造影J-CTO评分密切相关（平均值：1.8 ± 1.3，r = 0.856，p < 0.001），171处病变中有122处（71%）的评分相同。两个J-CTOCT评分（曲线下面积：0.882，p < 0.001）和血管造影J-CTO评分（曲线下面积：0.868，p < 0.001）对30分钟内成功通过导丝产生了类似的高预测值（p = 0.496）。虽然冠状动脉CTA中冠状动脉闭塞的长度明显短于侵入性血管造影，通过冠状动脉CTA确定的J-CTOCT评分与血管造影J-CTO评分密切相关。(C)2015年心血管计算机断层扫描学会。爱思唯尔公司出版All rights reserved.
Objectives: The J-CTO score is based on invasive angiography, combines several parameters of chronic total coronary occlusions (CTO), and is well established to predict the likelihood of success of percutaneous recanalization. The Purpose of this study was to evaluate and validate a J-CTOCT score derived from coronary computed tomography angiography (coronary CTA).Methods: Between April 2011 and December 2014, 159 consecutive patients were retrospectively included. All had at least one CTO in invasive angiography, had coronary CTA performed at an interval of no more than one week from invasive angiography, and had an attempt at percutaneous coronary intervention (PCI) following coronary CTA In parallel to the angiographic J-CTO score, the J-CTOCT score was determined by awarding one point each for a blunt vessel stump, bending > 45, occlusion length >= 20 mm, presence of calcium covering > 50% of any vessel cross-section within the occlusion, or a previously failed attempt at PCI. a. Both scores were compared regarding their ability to predict successful recanalization.Results: A total of 171 CTO lesions were analyzed. Intraobserver (k = 0.814, p < 0.001) and interobserver agreement (k = 0.771, p < 0.001) for calculation of the J-CTOCT score were close. The mean occlusion length measured by coronary CTA was significantly shorter than in invasive angiography (27.6 +/- 14.8 mm vs. 37.2 +/- 18.8 mm, p < 0.001). The J-CTOCT score (mean: 1.9 +/- 1.4) correlated closely to the angiographic J-CTO score (mean: 1.8 +/- 1.3, r = 0.856, p < 0.001), and in 122/171 lesions (71%), the scores were identical. Both J-CTOCT score (area under curve: 0.882, p < 0.001) and angiographic J-CTO score (area under curve: 0.868, p < 0.001) yielded similarly high predictive value for successful guidewire crossing within 30 min (p = 0.496).Conclusions: While the length of coronary occlusions in coronary CTA is significantly shorter than in invasive angiography, a J-CTOCT score determined by coronary CTA closely correlates to the angiographic J-CTO score. (C) 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.