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Predicting the Success Rate of Elective Percutaneous Coronary Intervention for Prior Failed Chronic Total Occlusion: a Novel Scoring System

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Abstract

To investigate a scoring system for predicting the risk of successful percutaneous coronary intervention (PCI) after prior failed chronic total occlusion (CTO). Patients with previously attempted CTO-PCI were enrolled in our study retrospectively from January 2016 to December 2019. All clinical and procedural data were collected and analyzed. Univariate and multivariate logistic regression was performed to investigate the predictors of technical success. A total of 194 patients/CTO lesions were studied. The multivariate logistic regression showed that occlusion length < 20 mm (odds ratio (OR) = 2.94, score = 1), non-calcification (OR = 2.93, score = 1), adequate distal landing zone (OR = 4.46, score = 1), Rentrop grade ≥ 2 (OR = 5.98, score = 1), and retrograde approach as the initial strategy (OR = 10.28, score = 2) were predictors of the success of re-attempt PCI. The technical success rate for scores from 0 to ≥ 4 were 0%, 17.9%, 46.2%, 77.8%, and 93.3% respectively. Our scoring system can be used to predict the success rate of re-attempt CTO-PCI.

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Abbreviations

PCI:

Percutaneous coronary intervention

CTO:

Chronic total occlusion

MACE:

Major adverse cardiac events

ISR:

In-stent restenosis

TIMI:

Thrombolysis in Myocardial Infarction

CC:

Collateral connection

IQR:

Interquartile range

ROC:

Receiver operating characteristic

AUC:

Area under curve

LAD:

Left anterior descending

LCx:

Left circumflex

RCA:

Right coronary artery

DR:

Dissection re-entry

GW:

Guidewire

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Funding

The work was supported by the National Natural Science Foundation of China (81970291).

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Authors and Affiliations

  1. Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Wenzheng Li, Zheng Wu, Hongyu Peng, Donghui Zhao, Ze Zheng, Shiying Li, Shujuan Cheng & Jinghua Liu

  2. Central hospital afflicted to Shenyang Medical College, Shenyang, China

    Bing Tian

  3. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China

    Jinghua Liu

Authors
  1. Wenzheng Li
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  2. Zheng Wu
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  3. Hongyu Peng
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  4. Donghui Zhao
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  5. Ze Zheng
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  6. Bing Tian
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  7. Shiying Li
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  9. Jinghua Liu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Wenzheng Li, Zheng Wu, Hongyu Peng, Donghui Zhao, Ze Zheng, Bing Tian, Shiying Li, Shujuan Cheng, and Jinghua Liu. The first draft of the manuscript was written by Wenzheng Li and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jinghua Liu.

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Ethical Approval

Ethical approval was waived by Beijing Anzhen Hospital, Capital Medical University in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Informed Consent

Verbal informed consent was obtained prior to the interview.

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The authors declare no competing interests.

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Associate Editor Angela Taylor oversaw the review of this article.

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Li, W., Wu, Z., Peng, H. et al. Predicting the Success Rate of Elective Percutaneous Coronary Intervention for Prior Failed Chronic Total Occlusion: a Novel Scoring System. J. of Cardiovasc. Trans. Res. 15, 797–804 (2022). https://doi.org/10.1007/s12265-021-10193-x

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  • DOI: https://doi.org/10.1007/s12265-021-10193-x

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