Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention
Abstract Objectives The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. Background Coronary CT...
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| Veröffentlicht in: | JACC. Cardiovascular imaging 2018-02, Vol.11 (2), p.209-217 |
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| creator | Fujino, Akiko, MD Otsuji, Satoru, MD Hasegawa, Katsuyuki, MD Arita, Toyohiro, RT Takiuchi, Shin, MD, PhD Fujii, Kenichi, MD, PhD Yabuki, Masanori, MD, PhD Ibuki, Motoaki, MD Nagayama, Shinya, MD Ishibuchi, Kasumi, MD Kashiyama, Toshikazu, MD Ishii, Rui, MD, PhD Tamaru, Hiroto, MD Yamamoto, Wataru, MD Hara, Masahiko, MD, PhD Higashino, Yorihiko, MD |
| description | Abstract Objectives The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. Background Coronary CTA can be used to assess the morphology of CTO lesions. Methods We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI. The J-CTO (Multicenter CTO Registry of Japan) score (the sum of the following 5 binary parameters: blunt proximal cap, calcification, bending >45°, and length of occluded segment >20 mm plus previously failed PCI attempt) was calculated using both CTA and conventional coronary angiography and compared. Results The median patient age was 69 years (interquartile range: 62 to 75 years), 82.4% were male, and a retrograde approach was attempted in 72 (33.0%) cases. The procedural success rate of the CTO-PCI procedures was 82.6%, and 29.4% of cases achieved 30-min wire crossing. The areas under the curve of the CTA-derived J-CTO score for predicting procedural success and 30-min wire crossing were significantly greater than those derived from conventional angiography (0.855 vs. 0.698; p < 0.001 for procedural success and 0.812 vs. 0.692; p < 0.001, for 30-min wire crossing). In addition, the areas under the curve of CTA-derived evaluations of calcification, bending, and occlusion length were significantly higher than those of derived from angiography for predicting procedural success. Conclusions The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography. |
| doi_str_mv | 10.1016/j.jcmg.2017.01.028 |
| format | Article |
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Background Coronary CTA can be used to assess the morphology of CTO lesions. Methods We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI. The J-CTO (Multicenter CTO Registry of Japan) score (the sum of the following 5 binary parameters: blunt proximal cap, calcification, bending >45°, and length of occluded segment >20 mm plus previously failed PCI attempt) was calculated using both CTA and conventional coronary angiography and compared. Results The median patient age was 69 years (interquartile range: 62 to 75 years), 82.4% were male, and a retrograde approach was attempted in 72 (33.0%) cases. The procedural success rate of the CTO-PCI procedures was 82.6%, and 29.4% of cases achieved 30-min wire crossing. The areas under the curve of the CTA-derived J-CTO score for predicting procedural success and 30-min wire crossing were significantly greater than those derived from conventional angiography (0.855 vs. 0.698; p < 0.001 for procedural success and 0.812 vs. 0.692; p < 0.001, for 30-min wire crossing). In addition, the areas under the curve of CTA-derived evaluations of calcification, bending, and occlusion length were significantly higher than those of derived from angiography for predicting procedural success. Conclusions The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography.</description><identifier>ISSN: 1936-878X</identifier><identifier>EISSN: 1876-7591</identifier><identifier>DOI: 10.1016/j.jcmg.2017.01.028</identifier><identifier>PMID: 28624404</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiovascular ; chronic total occlusion ; computed tomography ; coronary angiography ; percutaneous coronary intervention</subject><ispartof>JACC. Cardiovascular imaging, 2018-02, Vol.11 (2), p.209-217</ispartof><rights>American College of Cardiology Foundation</rights><rights>2018 American College of Cardiology Foundation</rights><rights>Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-48a15c008e5cea69f11e0d05abf7ccfba3f4cf4c66f75a0cd0a99e220085bb883</citedby><cites>FETCH-LOGICAL-c455t-48a15c008e5cea69f11e0d05abf7ccfba3f4cf4c66f75a0cd0a99e220085bb883</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcmg.2017.01.028$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28624404$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fujino, Akiko, MD</creatorcontrib><creatorcontrib>Otsuji, Satoru, MD</creatorcontrib><creatorcontrib>Hasegawa, Katsuyuki, MD</creatorcontrib><creatorcontrib>Arita, Toyohiro, RT</creatorcontrib><creatorcontrib>Takiuchi, Shin, MD, PhD</creatorcontrib><creatorcontrib>Fujii, Kenichi, MD, PhD</creatorcontrib><creatorcontrib>Yabuki, Masanori, MD, PhD</creatorcontrib><creatorcontrib>Ibuki, Motoaki, MD</creatorcontrib><creatorcontrib>Nagayama, Shinya, MD</creatorcontrib><creatorcontrib>Ishibuchi, Kasumi, MD</creatorcontrib><creatorcontrib>Kashiyama, Toshikazu, MD</creatorcontrib><creatorcontrib>Ishii, Rui, MD, PhD</creatorcontrib><creatorcontrib>Tamaru, Hiroto, MD</creatorcontrib><creatorcontrib>Yamamoto, Wataru, MD</creatorcontrib><creatorcontrib>Hara, Masahiko, MD, PhD</creatorcontrib><creatorcontrib>Higashino, Yorihiko, MD</creatorcontrib><title>Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention</title><title>JACC. Cardiovascular imaging</title><addtitle>JACC Cardiovasc Imaging</addtitle><description>Abstract Objectives The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. Background Coronary CTA can be used to assess the morphology of CTO lesions. Methods We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI. The J-CTO (Multicenter CTO Registry of Japan) score (the sum of the following 5 binary parameters: blunt proximal cap, calcification, bending >45°, and length of occluded segment >20 mm plus previously failed PCI attempt) was calculated using both CTA and conventional coronary angiography and compared. Results The median patient age was 69 years (interquartile range: 62 to 75 years), 82.4% were male, and a retrograde approach was attempted in 72 (33.0%) cases. The procedural success rate of the CTO-PCI procedures was 82.6%, and 29.4% of cases achieved 30-min wire crossing. The areas under the curve of the CTA-derived J-CTO score for predicting procedural success and 30-min wire crossing were significantly greater than those derived from conventional angiography (0.855 vs. 0.698; p < 0.001 for procedural success and 0.812 vs. 0.692; p < 0.001, for 30-min wire crossing). In addition, the areas under the curve of CTA-derived evaluations of calcification, bending, and occlusion length were significantly higher than those of derived from angiography for predicting procedural success. Conclusions The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography.</description><subject>Cardiovascular</subject><subject>chronic total occlusion</subject><subject>computed tomography</subject><subject>coronary angiography</subject><subject>percutaneous coronary intervention</subject><issn>1936-878X</issn><issn>1876-7591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kt-K1DAUxoso7rr6Al5ILr1pPaf_CyIM1dWVhV2YUbwL6enpmLFtZpN2YB7A9_BZfDJTZtcLL4TASQ7f93HyS4LgJUKEgPmbXbSjYRvFgEUEGEFcPgrOsSzysMgqfOz3VZKHZVF-OwueObcDyCFPi6fBWVzmcZpCeh78XBHNVtFRmE58DuvNjViTsSzes9UHbsWlNcPvX7UZ9vPkjxszmK1V--9H8ZWtm51YjVv90JqMuLXcaprEeiZi57q5F7dsaZ7UyMbLa2PNqOxRXI0T2wOPkzbj8-BJp3rHL-7rRfDl8sOm_hRe33y8qlfXIaVZNoVpqTAjgJIzYpVXHSJDC5lquoKoa1TSpeRXnndFpoBaUFXFcewdWdOUZXIRvD7l7q25m9lNctCOuO9Pw0msELEqsxS9ND5JyRrnLHdyb_XgB5cIcsEvd3LBLxf8ElB6_N706j5_bgZu_1oeeHvB25OA_S0Pmq10pHkkz8wyTbI1-v_57_6xU69HTar_wUd2OzPb0fOTKF0sQa6XD7C8PxYJpICY_AHQK68g</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Fujino, Akiko, MD</creator><creator>Otsuji, Satoru, MD</creator><creator>Hasegawa, Katsuyuki, MD</creator><creator>Arita, Toyohiro, RT</creator><creator>Takiuchi, Shin, MD, PhD</creator><creator>Fujii, Kenichi, MD, PhD</creator><creator>Yabuki, Masanori, MD, PhD</creator><creator>Ibuki, Motoaki, MD</creator><creator>Nagayama, Shinya, MD</creator><creator>Ishibuchi, Kasumi, MD</creator><creator>Kashiyama, Toshikazu, MD</creator><creator>Ishii, Rui, MD, PhD</creator><creator>Tamaru, Hiroto, MD</creator><creator>Yamamoto, Wataru, MD</creator><creator>Hara, Masahiko, MD, PhD</creator><creator>Higashino, Yorihiko, MD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention</title><author>Fujino, Akiko, MD ; Otsuji, Satoru, MD ; Hasegawa, Katsuyuki, MD ; Arita, Toyohiro, RT ; Takiuchi, Shin, MD, PhD ; Fujii, Kenichi, MD, PhD ; Yabuki, Masanori, MD, PhD ; Ibuki, Motoaki, MD ; Nagayama, Shinya, MD ; Ishibuchi, Kasumi, MD ; Kashiyama, Toshikazu, MD ; Ishii, Rui, MD, PhD ; Tamaru, Hiroto, MD ; Yamamoto, Wataru, MD ; Hara, Masahiko, MD, PhD ; Higashino, Yorihiko, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-48a15c008e5cea69f11e0d05abf7ccfba3f4cf4c66f75a0cd0a99e220085bb883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cardiovascular</topic><topic>chronic total occlusion</topic><topic>computed tomography</topic><topic>coronary angiography</topic><topic>percutaneous coronary intervention</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fujino, Akiko, MD</creatorcontrib><creatorcontrib>Otsuji, Satoru, MD</creatorcontrib><creatorcontrib>Hasegawa, Katsuyuki, MD</creatorcontrib><creatorcontrib>Arita, Toyohiro, RT</creatorcontrib><creatorcontrib>Takiuchi, Shin, MD, PhD</creatorcontrib><creatorcontrib>Fujii, Kenichi, MD, PhD</creatorcontrib><creatorcontrib>Yabuki, Masanori, MD, PhD</creatorcontrib><creatorcontrib>Ibuki, Motoaki, MD</creatorcontrib><creatorcontrib>Nagayama, Shinya, MD</creatorcontrib><creatorcontrib>Ishibuchi, Kasumi, MD</creatorcontrib><creatorcontrib>Kashiyama, Toshikazu, MD</creatorcontrib><creatorcontrib>Ishii, Rui, MD, PhD</creatorcontrib><creatorcontrib>Tamaru, Hiroto, MD</creatorcontrib><creatorcontrib>Yamamoto, Wataru, MD</creatorcontrib><creatorcontrib>Hara, Masahiko, MD, PhD</creatorcontrib><creatorcontrib>Higashino, Yorihiko, MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fujino, Akiko, MD</au><au>Otsuji, Satoru, MD</au><au>Hasegawa, Katsuyuki, MD</au><au>Arita, Toyohiro, RT</au><au>Takiuchi, Shin, MD, PhD</au><au>Fujii, Kenichi, MD, PhD</au><au>Yabuki, Masanori, MD, PhD</au><au>Ibuki, Motoaki, MD</au><au>Nagayama, Shinya, MD</au><au>Ishibuchi, Kasumi, MD</au><au>Kashiyama, Toshikazu, MD</au><au>Ishii, Rui, MD, PhD</au><au>Tamaru, Hiroto, MD</au><au>Yamamoto, Wataru, MD</au><au>Hara, Masahiko, MD, PhD</au><au>Higashino, Yorihiko, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention</atitle><jtitle>JACC. Cardiovascular imaging</jtitle><addtitle>JACC Cardiovasc Imaging</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>11</volume><issue>2</issue><spage>209</spage><epage>217</epage><pages>209-217</pages><issn>1936-878X</issn><eissn>1876-7591</eissn><abstract>Abstract Objectives The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. Background Coronary CTA can be used to assess the morphology of CTO lesions. Methods We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI. The J-CTO (Multicenter CTO Registry of Japan) score (the sum of the following 5 binary parameters: blunt proximal cap, calcification, bending >45°, and length of occluded segment >20 mm plus previously failed PCI attempt) was calculated using both CTA and conventional coronary angiography and compared. Results The median patient age was 69 years (interquartile range: 62 to 75 years), 82.4% were male, and a retrograde approach was attempted in 72 (33.0%) cases. The procedural success rate of the CTO-PCI procedures was 82.6%, and 29.4% of cases achieved 30-min wire crossing. The areas under the curve of the CTA-derived J-CTO score for predicting procedural success and 30-min wire crossing were significantly greater than those derived from conventional angiography (0.855 vs. 0.698; p < 0.001 for procedural success and 0.812 vs. 0.692; p < 0.001, for 30-min wire crossing). In addition, the areas under the curve of CTA-derived evaluations of calcification, bending, and occlusion length were significantly higher than those of derived from angiography for predicting procedural success. Conclusions The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28624404</pmid><doi>10.1016/j.jcmg.2017.01.028</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Cardiovascular chronic total occlusion computed tomography coronary angiography percutaneous coronary intervention |
| title | Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention |
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