Guelker J E, Bansemir L, Ott R, Rock T, Kroeger K, Guelker R, Klues H G, Shin D I, Bufe A
Heartcentre Niederrhein, Department of Cardiology, Helios Clinic Krefeld, Germany; Institute for Heart and Circulation Research, University Cologne, Germany.
Heartcentre Niederrhein, Department of Cardiology, Helios Clinic Krefeld, Germany; Institute for Heart and Circulation Research, University Cologne, Germany.
Int J Cardiol. 2017 Mar 1;230:228-231. doi: 10.1016/j.ijcard.2016.12.165. Epub 2016 Dec 27.
Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge in interventional cardiology. To predict the probability of a successful intervention different scoring systems are available. We analyzed in this study the validity of two scoring systems, the Japanese CTO score (J-CTO score) and the newly developed Clinical and Lesion-related score (CL Score).
Between 2012 and 2015 we included 379 consecutive patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention.
Patients undergoing CTO PCI were mainly men (84%). The overall procedural success rate was 84% (±0.4). The mean J-CTO score was 2.9 (±1.3) and the mean CL score was 4.3 (±1.7). The CL score predicted more precisely the interventional results than the J-CTO score.
Our study suggests that the previously presented CL score is superior to the J-CTO score in identifying CTO lesions with a likelihood for successful recanalization. Generally it appears to be a helpful tool for selecting patients and identifying the appropriate operator.
完全慢性冠状动脉闭塞(CTO)的经皮冠状动脉介入治疗(PCI)仍是介入心脏病学中的一项重大挑战。为预测成功介入的概率,有多种评分系统可供使用。在本研究中,我们分析了两种评分系统的有效性,即日本CTO评分(J-CTO评分)和新开发的临床与病变相关评分(CL评分)。
2012年至2015年期间,我们纳入了379例连续患者。他们因至少一处CTO接受了PCI治疗。采用了正向和逆向CTO技术。仅在正向介入失败后才使用逆向方法。
接受CTO PCI治疗的患者主要为男性(84%)。总体手术成功率为84%(±0.4)。J-CTO评分的平均值为2.9(±1.3),CL评分的平均值为4.3(±1.7)。与J-CTO评分相比,CL评分能更准确地预测介入结果。
我们的研究表明,在识别具有成功再通可能性的CTO病变方面,先前提出的CL评分优于J-CTO评分。总体而言,它似乎是选择患者和确定合适术者的有用工具。