Validation of the OPEN-CLEAN Chronic Total Occlusion Percutaneous Coronary Intervention Perforation Score in a Multicenter Registry
Recommended Citation
Simsek B, Carlino M, Ojeda S, Pan M, Rinfret S, Vemmou E, Kostantinis S, Nikolakopoulos I, Karacsonyi J, Quadros AS, Dens JA, Abi Rafeh N, Agostoni P, Alaswad K, Avran A, Belli KC, Choi JW, Elguindy A, Jaffer FA, Doshi D, Karmpaliotis D, Khatri JJ, Khelimskii D, Knaapen P, La Manna A, Krestyaninov O, Lamelas P, Padilla L, de Oliveira PP, Spratt JC, Tanabe M, Walsh S, Goktekin O, Gorgulu S, Mastrodemos OC, Allana S, Rangan BV, Kearney KE, Lombardi WL, Grantham JA, Hirai T, Brilakis ES, and Azzalini L. Validation of the OPEN-CLEAN Chronic Total Occlusion Percutaneous Coronary Intervention Perforation Score in a Multicenter Registry. Am J Cardiol 2023; 188:30-35.
Document Type
Article
Publication Date
2-1-2023
Publication Title
The American journal of cardiology
Abstract
Coronary artery perforation is one of the most common and feared complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We evaluated the utility of the recently presented OPEN-CLEAN (Coronary artery bypass graft, Length of occlusion, Ejection fraction, Age, calcificatioN) perforation score in an independent multicenter CTO PCI dataset. Of the 2,270 patients who underwent CTO PCI at 7 centers, 150 (6.6%) suffered coronary artery perforation. Patients with perforations were older (69 ± 10 vs 65 ± 10, p <0.001), more likely to be women (89% vs 82%, p = 0.010), more likely to have history of previous coronary artery bypass graft (38% vs 20%, p <0.001), and unfavorable angiographic characteristics such as blunt stump (64% vs 42%, p <0.001), proximal cap ambiguity (51% vs 33%, p <0.001), and moderate-severe calcification (57% vs 43%, p = 0.001). Technical success was lower in patients with perforations (69% vs 85%, p <0.001). The area under the receiver operating characteristic curve of the OPEN-CLEAN perforation risk model was 0.74 (95% confidence interval 0.68 to 0.79), with good calibration (Hosmer-Lemeshow p = 0.72). We found that the CTO PCI perforation risk increased with higher OPEN-CLEAN scores: 3.5% (score 0 to 1), 3.1% (score 2), 5.3% (score 3), 7.1% (score 4), 11.5% (score 5), 19.8% (score 6 to 7). In conclusion, given its good performance and ease of preprocedural calculation, the OPEN-CLEAN perforation score appears to be useful for quantifying the perforation risk for patients who underwent CTO PCI.
Medical Subject Headings
Humans; Female; Male; Risk Factors; Percutaneous Coronary Intervention; Treatment Outcome; Coronary Angiography; Coronary Occlusion; Chronic Disease; Vascular System Injuries; Registries
PubMed ID
36462272
Volume
188
First Page
30
Last Page
35
