Visually Estimated RESOLVE Score Based on Coronary Computed Tomography to Predict Side Branch Occlusion in Percutaneous Bifurcation Intervention

医学 经皮冠状动脉介入治疗 闭塞 一致性 计算机断层血管造影 冠状动脉闭塞 心脏病学 四分位数 溶栓 放射科 接收机工作特性 心肌梗塞 核医学 内科学 血管造影 置信区间
作者
Anna M. Michałowska,Kajetan Grodecki,Adam D. Staruch,Cezary Kępka,Rafał Wolny,Jerzy Pręgowski,Mariusz Kruk,Mariusz Dębski,Artur Dębski,Ilona Michałowska,Adam Witkowski,Maksymilian P. Opolski
出处
期刊:Journal of Thoracic Imaging [Lippincott Williams & Wilkins]
卷期号:36 (3): 189-196
标识
DOI:10.1097/rti.0000000000000570
摘要

Purpose: The quantitative RESOLVE (Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion) score derived from coronary computed tomography angiography (coronary CTA) was developed as a noninvasive and accurate prediction tool for side branch (SB) occlusion in coronary bifurcation intervention. We aimed to determine the ability of a visually estimated CTA-derived RESOLVE score (V-RESOLVE score) to predict SB occlusion in coronary bifurcation intervention. Materials and Methods: The present study included 363 patients with 400 bifurcation lesions. CTA-derived V-RESOLVE score was derived and compared with the quantitative CTA-derived RESOLVE score. The scoring systems were divided into quartiles, and classified as the high-risk and non–high-risk groups. SB occlusion was defined as any decrease in thrombolysis in myocardial infarction flow grade after main vessel stenting. Results: In total, 28 SB occlusions (7%) occurred. The concordance between visual and quantitative CTA analysis showed poor to excellent agreement (weighted κ range: 0.099 to 0.867). The area under the receiver operating curve for the prediction of SB occlusion was significantly higher for the CTA-derived V-RESOLVE score than for quantitative CTA-derived RESOLVE score (0.792 vs. 0.709, P =0.049). The total net reclassification index was 42.7% ( P =0.006), and CTA-derived V-RESOLVE score showed similar capability to discriminate between high-risk group (18.6% vs. 13.8%, P =0.384) and non–high-risk group (3.8% vs. 4.9%, P =0.510) as compared with quantitative CTA-derived RESOLVE score. Conclusions: Visually estimated CTA-derived V-RESOLVE score is an accurate and easy-to-use prediction tool for the stratification of SB occlusion in coronary bifurcation intervention.

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