Korean J Radiol.  2021 May;22(5):697-705. 10.3348/kjr.2020.0732.

CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

• Li J
• Wang R
• Tesche C
• Schoepf UJ
• Pannell JT
• He Y
• Huang R
• Chen Y
• Li J
• Song X

• KMID: 2515058
• DOI: http://doi.org/10.3348/kjr.2020.0732

Abstract

Objective
To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGE _CCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).
Materials and Methods
One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent _CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGE _CCTA scores were calculated and compared with RECHARGE_CA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores.
Results
The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGE _CCTA score and the RECHARGE_CA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGE _CCTA score was higher than the RECHARGE _CA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGE _CCTA and RECHARGE _CA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGE _CCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGE _CCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665–0.717, all p > 0.05).
Conclusion
The non-invasive RECHARGE _CCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGE_CCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

Keyword

Coronary artery disease; Coronary angiography; Percutaneous coronary intervention; Computed tomography angiography