Int J Angiol 2020; 29(03): 196-201
DOI: 10.1055/s-0040-1709503
Original Article

Coronary Angiography Characteristics as Predictor of Successful Chronic Total Occlusion Recanalization

Yudi Her Oktaviono
1  Department of Cardiology and Vascular Medicine, Airlangga University, East Java, Indonesia
,
Ardian Rizal
2  Departement of Cardiology and Vascular Medicine, Faculty of Medicine Brawijaya University—Dr. Saiful Anwar General Hospital, East Java, Indonesia
,
Makhyan Jibril Al-Farabi
1  Department of Cardiology and Vascular Medicine, Airlangga University, East Java, Indonesia
,
Irma Maghfirah
1  Department of Cardiology and Vascular Medicine, Airlangga University, East Java, Indonesia
,
Dita Aulia Rachmi
1  Department of Cardiology and Vascular Medicine, Airlangga University, East Java, Indonesia
› Author Affiliations

Abstract

Although remarkable progress in percutaneous coronary intervention (PCI) has been achieved over the last decade, the success rate of chronic total occlusion (CTO) recanalization varies greatly. Coronary angiography characteristics may affect the success rate of CTO recanalization. This study sought to establish a scoring model to predict successful CTO recanalization based on coronary angiography characteristics. We analyze 287 angiography data from patients who underwent elective PCI. Angiography characteristics being measured were lesion location, blunt stump, calcification, ostial lesion, bridging collateral, bending, side branch, tortuosity, previous stent attempt, and lesion length of >20 mm. Data were analyzed using SPSS 25.0. Multivariate analysis shows that side branch lesion (p = 0.000), proximal vessels tortuosity (p = 0.015), calcified lesion (p = 0.000), lesion length of >20 mm (p = 0.000), and blunt stump (p = 0.000) can predict the successful PCI in the CTO. ROC curve analysis of the score ability to predict successful PCI in the CTO showed area under curve of 0.89 (confidence interval 95%), the cutoff point of ≤2 with a sensitivity of 93.33%, and specificity of 88.23%. We concluded that the five angiography characteristics that strongly associate with successful PCI in the CTO are calcified lesion, blunt stump, lesion length >20 mm, proximal vessel tortuosity, and side branch lesion. This score may help cardiologists to predict the success probability of PCI in the CTO.

Note

PROGRESS CTO: The Prospective Global Registry for the Study of Chronic Total Occlusion


EURO-CTO: A Randomized Multicentre Trial to Evaluate the Utilization of Revascularization or Optimal Medical Therapy for the Treatment of Chronic Total Occlusions


TOAST-GISE: Total Occlusion Angioplasty Study-Società Italiana di Cardiologia Invasiva




Publication History

Publication Date:
30 June 2020 (online)

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