Coronary disease & ACSCohort study
New Angiographic Difficulty Score for First-Attempt Chronic Total Occlusion in the 3 Major Coronary Arteries
- Registry-based cohort study (difficulty score derivation and validation)
- multicentre registry
- derivation and validation sets
Authors' conclusion
Clinical and angiographic differences might explain the discrepancies of success rates in CTO lesions among the 3 major coronary arteries. Our novel difficulty score was comparable to the J-CTO score in predicting unsuccessful CTO-PCI with a superior discriminatory capacity.
Study context
- Population
- First-attempt chronic total occlusion (CTO) percutaneous coronary intervention (PCI) patients, Japanese CTO-PCI expert registry, January 2014 to December 2021
- Participants
- 6,408 patients
- Exposure
- Artery-specific difficulty scores vs J-CTO score for predicting unsuccessful CTO-PCI
- Left anterior descending coronary arteryn = 2,245
- Left circumflex coronary arteryn = 1,131
- Right coronary artery (RCA)n = 3,032
- Outcome
- Predictors of unsuccessful PCI in first-attempt CTO lesions of the 3 major coronary arteries, compared with the J-CTO score
Main finding
As reported in the abstract
Procedural success rate
Observational data: associations, not effects.
Further findings
RCA CTO lesion characteristics
- RCA CTO significantly longer and more severely angulated, more often requiring the retrograde approach
Original publication
New Angiographic Difficulty Score for First-Attempt Chronic Total Occlusion in the 3 Major Coronary Arteries. JACC Cardiovasc Interv. Published 23 October 2023. doi:10.1016/j.jcin.2023.08.046
Summarised from the published abstract; every number is checked against it