摘要
目的:验证在冠状动脉慢性完全闭塞病变(CTO)中B-CTO评分预测介入治疗成功率及难易程度的可行性。方法:根据病变CTO病理解剖学特征对650例CTO患者进行评分,0~3分难度系数定义为'简单',4~6分难度系数定义为'中等',7~9分难度系数定义为'困难',10~12分难度系数定义为'极困难'。观察不同组之间手术成功率,评估B-CTO评分与手术成功和手术时间的关系。结果:B-CTO评分简单组,高达97%的患者通过正向途径取得成功,随着评分难度增加,直接正向夹层再进入技术及逆向技术的使用比例逐渐升高,极困难组逆向比例61%。B-CTO评分预测手术失败的ROC曲线下面积为0.87。结论:B-CTO评分有助于预测CTO手术难易程度,可用做CTO介入治疗术前的评分工具。
Objective:To observe the performance of the buddy-chronic total occlusion(B-CTO)score in predicting success and efficiency of coronary chronic total occlusion(CTO)percutaneous coronary interventions.Method:We examined the records of 650 consecutive patients who underwent CTO percutaneous coronary intervention between 2016 and 2018 at 26 experienced centers in the China.Six hundred and fifty-seven lesions were classified as easy(B-CTO=0-3),intermediate(B-CTO=4-6),difficult(B-CTO=7-9),and very difficult(B-CTO=10-12).The impact of the B-CTO score on technical success and procedure time was evaluated with univariable logistic and linear regression,respectively.The performance of the logistic regression model was assessed with the Hosmer-Lemeshow statistic and receiver operator characteristic curves.Result:Antegrade wiring techniques were used more frequently in easy lesions(97%)than very difficult lesions(58%),whereas the retrograde approach became more frequent with increased lesion difficulty(61%for very difficult lesions).The logistic regression model for technical success demonstrated satisfactory calibration and discrimination(AUC=0.87).Conclusion:B-CTO score was strongly associated with final success and efficiency in this study,supporting its expanded use in CTO interventions.
作者
胡涛
孔令秋
李长岭
张宇晨
马剑英
尹达
聂斌
葛均波
HU Tao;KONG Lingqiu;LI Changling;ZHANG Yuchen;MA Jianying;YIN Da;NIE Bin;GE Junbo(Department of Cardiology,Xijing Hospital,Air Force Military Medical University,Xi'an,710032,China;Department of Cardiology,Zhongshan Hospital,Fudan University;Department of Cardiology,the Second Hospital Affiliated to Zhejiang University;Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University;Department of Cardiology,Cardiovascular Hospital of Dalian Medical University)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第6期495-500,共6页
Journal of Clinical Cardiology
关键词
冠状动脉疾病
血管成形术
冠状动脉介入治疗
放射
coronary artery disease
angioplasty
percutaneous coronary intervention
radiation
