Objective. With the rapid development of technology and experience, the current percutaneous coronary intervention of chronic total occlusion (CTO-PCI) preoperative scoring model needs to be updated. This study aimed to evaluate the clinical value of the operator-CTO score in predicting the outcome of interventional therapy for chronic total occlusion of the coronary artery. Methods. The data of 144 lesions in 130 patients with CTO were analyzed prospectively. The CTO procedures were performed by 10 operators with different skills and experiences. Before the procedures, J-CTO, progress, ORA, recharge, and operator-CTO scores were determined. Then, the clinical, imaging, and procedural data of patients in different operator-CTO score groups and between different operators were compared. The final focus was on comparing the predictive ability of each score on the outcome of CTO-PCI. Results. The overall technical and procedural success rates were 90.9% and 88.9%, respectively. A decreasing trend in the technical success of CTO-PCI was observed according to the operator-CTO score hierarchy of “easy (≤2 points), moderate (3 points), difficult (4 points), and extremely difficult (≥5 points)” (99.0%, 87.5%, 53.8%, and 25.0%, respectively). All five scoring models were well calibrated, and the area under the curve (AUC) for the operator-CTO score was 0.901 (95% CI: 0.821–0.982, ), larger than the AUC for the remaining four scoring models, showing excellent ability to predict technical outcomes. Conclusion. The operator-CTO score is a new clinical scoring tool that can predict the outcome of CTO-PCI and can be used to grade the difficulty of the procedure, with the potential to work well with a broad group of operators.

中文翻译：

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冠状动脉慢性完全闭塞介入治疗的新型临床评分模型

客观。随着技术和经验的快速发展，目前的经皮冠状动脉介入治疗慢性完全闭塞（CTO-PCI）术前评分模型需要更新。本研究旨在评估operator-CTO评分在预测冠状动脉慢性完全闭塞介入治疗结果中的临床价值。方法. 前瞻性分析了130例CTO患者144个病灶的数据。CTO 程序由 10 名具有不同技能和经验的操作员执行。在程序之前，确定了 J-CTO、进度、ORA、再充电和操作员-CTO 分数。然后，比较不同操作者-CTO评分组和不同操作者之间患者的临床、影像学和手术数据。最后的重点是比较每个评分对 CTO-PCI 结果的预测能力。结果. 总体技术和程序成功率分别为 90.9% 和 88.9%。根据操作员-CTO评分等级，“容易（≤2分）、中等（3分）、困难（4分）和极难（≥5分），CTO-PCI技术成功率呈下降趋势。 ”（分别为 99.0%、87.5%、53.8% 和 25.0%）。所有五个评分模型均经过良好校准，操作员-CTO 评分的曲线下面积 (AUC) 为 0.901 (95% CI: 0.821–0.982,)，大于其余四个评分模型的 AUC，显示出预测技术结果的出色能力。结论。操作员-CTO 评分是一种新的临床评分工具，可以预测 CTO-PCI 的结果，可用于对手术难度进行分级，具有与广大操作员良好合作的潜力。