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

Wenzheng Li1, Zheng Wu1, Hongyu Peng1

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

Journal of Cardiovascular Translational Research
|August 1, 2022
PubMed

Insights

A new scoring system accurately predicts success for re-attempting percutaneous coronary intervention (PCI) in chronic total occlusions (CTO). Factors like lesion length and retrograde approach significantly influence PCI success rates.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has a significant failure rate.
  • Predicting success for re-attempting CTO-PCI is crucial for patient management and resource allocation.

Purpose of the Study:

  • To develop and validate a scoring system for predicting the technical success of re-attempting PCI in patients with CTO.
  • Identify key predictors of successful CTO-PCI re-intervention.

Main Methods:

  • Retrospective analysis of 194 patients who underwent attempted CTO-PCI between January 2016 and December 2019.
  • Multivariate logistic regression analysis to identify predictors of technical success.
  • Development of a scoring system based on identified predictors.

Main Results:

  • Key predictors of successful re-attempt CTO-PCI include occlusion length < 20 mm, non-calcification, adequate distal landing zone, Rentrop grade ≥ 2, and initial retrograde approach.
  • The scoring system demonstrated increasing technical success rates with higher scores (0% for score 0 to 93.3% for score ≥ 4).

Conclusions:

  • The developed scoring system effectively predicts the likelihood of technical success for re-attempting CTO-PCI.
  • This tool can aid clinicians in decision-making and patient selection for complex PCI procedures.

Keywords:
Chronic total occlusionCoronary artery diseasePercutaneous coronary interventionPrevious failure

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