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Published on: August 9, 2024
A Chinese scoring system for predicting successful retrograde collateral traverse in patients with chronic total
Qiu Yu Li1, Xiao Long Lin1, Fan Qi Li1
1Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China.
Insights
A new Chinese scoring system, the ACT score, reliably predicts successful retrograde collateral channel crossing in chronic total occlusion (CTO) percutaneous coronary intervention. This tool aids in planning complex CTO treatments.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Biology
Background:
- Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) presents challenges, particularly with retrograde approach techniques.
- Successful collateral channel traversal is crucial for retrograde CTO PCI.
Purpose of the Study:
- To develop and validate a novel Chinese scoring system to predict successful collateral channel traversal using the retrograde approach in CTO patients.
Main Methods:
- Analysis of demographic and angiographic characteristics of 309 CTO patients.
- Univariable and multivariable analyses to identify predictors.
- Development of a nomogram-based scoring system (ACT score) using Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity.
Main Results:
- The ACT score identified key predictors for successful retrograde approach.
- The scoring system demonstrated good calibration with an area under the curve of 0.826 (internal validation) and 0.816 (external validation).
- Risk stratification into three categories showed consistent predictive power in validation cohorts.
Conclusions:
- The novel Chinese ACT score is a reliable and validated tool for predicting successful retrograde collateral traversal in CTO PCI.
- This scoring system can aid interventional cardiologists in planning and executing retrograde CTO interventions.
Background:
Retrograde approach technique has been challenging in percutaneous coronary interventional treatment of chronic total occlusion (CTO) coronary disease. The present study endeavors to determine a novel Chinese scoring system for predicting successful collateral channels traverse via retrograde approach.
Methods:
The demographic characteristics and angiographic characteristics of 309 CTO patient were analyzed by univariable and multivariable analysis for selecting potential predictors. And the nomogram was used to establish the scoring system. Then it was evaluated by the internal and external validation.
Results:
The predictors of Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity (ACT) were identified with univariable and multivariable analysis and employed to the ACT score system. With acceptable calibrations, the area under curve of the scoring system and the external validation were 0.826 and 0.816 respectively. Based on score, the predictors were divided into three risk categories and it showed a consistent prediction power in the validation cohort.
Conclusions:
The novel Chinese ACT score is a reliable tool for predicting successful retrograde collateral traverse.
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