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New scoring system for predicting percutaneous coronary intervention of chronic total occlusion success: Impact of operator’s experience
Affiliations- Interventional Cardiology Unit, Cardiology Division, Joan XXIII University Hospital, Pere Virgili Health Research Institute (IISPV), Tarragona, Spain
- Cardiology Division, Joan XXIII Univer sity Hospital, Pere Virgili Health Research Insitute (IISPV), Tarragona, Spain
open access
Abstract
Background: Several scoring systems have been developed in order to predict percutaneous coronary intervention (PCI) result of chronic total occlusion (CTO). The scores principally include anatomic and clinical variables. Operator experience is a decisive factor for achieving successful result. We sought to assess the real impact of operator growing experience on CTO-PCI success.
Methods: The angiographic and clinical variables of CTO-PCIs performed in our center between May 2007 and April 2021 were collected, and variables with potential association with procedural result were thoroughly reviewed. The influence of operator experience based on the number of previous CTO-PCIs was statistically assessed. A scoring system with combination of anatomic variables and operator experience was devised.
Results: A total of 540 PCIs in 457 patients were performed in our institution. The scoring model was developed from the derivation set (2/3 of the cohort). The final variables in logistic regression model were CTO length ≥ 20 mm, blunt stump, vessel tortuosity > 45o and operator experience < 100 PCIs. The model showed good performance in the derivation set (area under curve [AUC]: 0.768; confidence interval [CI]: 0706–0.830; p < 0.001) with no significant shrinkage in the validation set (AUC: 0.704; CI: 0.613–0.796; p < 0.001).
Conclusions: This new score (E-CTO score) adequately predict the probability of CTO-PCI failure. The model includes a variable representing operator experience along with other anatomic variables.
Abstract
Background: Several scoring systems have been developed in order to predict percutaneous coronary intervention (PCI) result of chronic total occlusion (CTO). The scores principally include anatomic and clinical variables. Operator experience is a decisive factor for achieving successful result. We sought to assess the real impact of operator growing experience on CTO-PCI success.
Methods: The angiographic and clinical variables of CTO-PCIs performed in our center between May 2007 and April 2021 were collected, and variables with potential association with procedural result were thoroughly reviewed. The influence of operator experience based on the number of previous CTO-PCIs was statistically assessed. A scoring system with combination of anatomic variables and operator experience was devised.
Results: A total of 540 PCIs in 457 patients were performed in our institution. The scoring model was developed from the derivation set (2/3 of the cohort). The final variables in logistic regression model were CTO length ≥ 20 mm, blunt stump, vessel tortuosity > 45o and operator experience < 100 PCIs. The model showed good performance in the derivation set (area under curve [AUC]: 0.768; confidence interval [CI]: 0706–0.830; p < 0.001) with no significant shrinkage in the validation set (AUC: 0.704; CI: 0.613–0.796; p < 0.001).
Conclusions: This new score (E-CTO score) adequately predict the probability of CTO-PCI failure. The model includes a variable representing operator experience along with other anatomic variables.
Keywords
percutaneous coronary intervention, coronary occlusions, coronary arteries
About this articleTitle
New scoring system for predicting percutaneous coronary intervention of chronic total occlusion success: Impact of operator’s experience
Journal
Issue
Article type
Original Article
Pages
506-515
Published online
2021-09-23
Page views
1719
Article views/downloads
629
DOI
Pubmed
Bibliographic record
Cardiol J 2023;30(4):506-515.
Keywords
percutaneous coronary intervention
coronary occlusions
coronary arteries
Authors
Mohsen Mohandes
Cristina Moreno
Mónica Fuertes
Sergio Rojas
Alberto Pernigotti
Diego Zambrano
Victor Doblas
Francisco Fernández
Jordi Guarinos
Alfredo Bardají
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