The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Predicting Successful Guidewire Crossing via Collateral Channel at Retrograde Percutaneous Coronary Intervention for Chronic Total Occlusion. The J-Channel Score as a Difficulty Estimating Tool for Collateral Channel Guidewire Crossing Success from the Japanese CTO-PCI Expert Registry

EuroIntervention 2019; just accepted article published in April 2019. DOI: 10.4244/EIJ-D-18-00993

1. Department of Cardiology, Hokusetsu General Hospital, Osaka, Japan, JAPAN; 2. Department of Cardiology, Toyohashi Heart Center, Aichi, Japan; 3. Department of Cardiovascular Medicine, Cardiovascular Institute, Tokyo, Japan; 4. Department of Cardiology for International Education and Research, Osaka University Graduate School of Medicine; 5. Cardiovascular Center Tokeidai Memorial Hospital, Sapporo, Japan; 6. Department of Cardiology, Sanda City Hospital, Sanda, Japan; 7. Division of Cardiology, Saitama Prefecture Cardiovascular and Respiratory Center, Saitama, Japan; 8. Division of Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan; 9. Japanese CTO-PCI Expert Foundation, Okayama, Japan
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Aims: Guidewire (GW) tracking in a collateral channel (CC) is an important step during retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The aim of this study was to create a prediction score model for CC GW crossing success.

Methods and results: We analyzed data on 886 CCs included in the Japanese CTO-PCI Expert Registry during 2016. CCs were categorized as septal (n = 610) and non-septal (n = 276). CCs were randomly assigned to derivation and validation sets in a 2:1 ratio. The score was developed by multivariate analysis with angiographic findings. Small vessel, reverse bend, and continuous bends were independent predictors in the septal CC subset. Small vessel, reverse bend, and corkscrew were independent predictors in the non-septal CC subset. The extent of intervention was easy, intermediate, and difficult at 92.9%, 57.4%, and 16.7% in the septal CC subset and 91.7%, 54.3%, and 19.0% in the non-septal CC, respectively, in the validation set. The area under the receiver–operator characteristics curve was >0.7 in derivation and validation sets of both CC subsets.

Conclusions: The prediction score model can suggest grading of the difficulty of CC GW crossing based on angiographic findings for each type of CC.

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