• Aris Karatasakis, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, John N Bahadorani, William L Lombardi, R Michael Wyman, J Aaron Grantham, David E Kandzari, Nicholas J Lembo, Anthony H Doing, Catalin Toma, Jeffrey W Moses, Ajay J Kirtane, Manish A Parikh, Ziad A Ali, Santiago Garcia, Pratik Kalsaria, Judit Karacsonyi, Aya J Alame, Craig A Thompson, Subhash Banerjee, and Emmanouil S Brilakis.
• VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, United States.
• Int. J. Cardiol. 2016 Dec 1; 224: 50-56.

BackgroundVarious scoring systems have been developed to predict the technical outcome and procedural efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).MethodsWe examined the predictive capacity of 3 CTO PCI scores (Clinical and Lesion-related [CL], Multicenter CTO registry in Japan [J-CTO] and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention [PROGRESS CTO] scores) in 664 CTO PCIs performed between 2012 and 2016 at 13 US centers.ResultsTechnical success was 88% and the retrograde approach was utilized in 41%. Mean CL, J-CTO and PROGRESS CTO scores were 3.9±1.9, 2.6±1.2 and 1.4±1.0, respectively. All scores were inversely associated with technical success (p<0.001 for all) and had moderate discriminatory capacity (area under the curve 0.691 for the CL score, 0.682 for the J-CTO score and 0.647 for the PROGRESS CTO score [p=non-significant for pairwise comparisons]). The difference in technical success between the minimum and maximum CL score strata was the highest (32%, vs. 15% for J-CTO and 18% for PROGRESS CTO scores). All scores tended to perform better in antegrade-only procedures and correlated significantly with procedure time and fluoroscopy dose; the CL score also correlated significantly with contrast utilization.ConclusionsCL, J-CTO and PROGRESS CTO scores perform moderately in predicting technical outcome of CTO PCI, with better performance for antegrade-only procedures. All scores correlate with procedure time and fluoroscopy dose, and the CL score also correlates with contrast utilization.Published by Elsevier Ireland Ltd.

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