An angiographic tool based on Visual estimation for Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion: the V-RESOLVE score system

作者：Dou Kefei; Zhang Dong; Xu Bo; Yang Yuejin; Yin Dong; Qiao Shubin; Wu Yongjian; You Shijie; Wang Yang; Yan Ruohua; Gao Runlin; Kirtane Ajay J

来源：Eurointervention, 2016, 11(14): E1604-E1611.

DOI：10.4244/EIJV11114A311

• coronary bifurcation lesion
• risk prediction
• score system
• side branch occlusion
• visual estimation

Aims: The RESOLVE score is a validated angiographic scoring system to evaluate the risk of side branch (SB) occlusion in bifurcation intervention. However, the inclusion of quantitative coronary angiography (QCA)-derived parameters limits its use in real-time procedures. We sought to evaluate the capability of risk prediction of SB occlusion based upon a visually estimated risk score (V-RESOLVE).
Methods and results: The present study included all of the lesions (N=1,601) analysed in the study for development and validation of the QCA-based RESOLVE score. An independent observer, blinded to previous QCA data, performed visual estimation to derive a V-RESOLVE score for each bifurcation procedure. The performance characteristics of the V-RESOLVE score were derived and compared to those of the QCAbased RESOLVE score. Considering the variability of visual estimation, statistical simulation of 30 different observers was performed to assess the performance of the V-RESOLVE score further. The SB occlusion rate was significantly higher in the high-risk group (16.7%) than in the non-high-risk group (4.3%) as assessed by the V-RESOLVE score. The consistency between visual estimation and QCA analysis showed fair to moderate agreement (weighted kappa range: 0.22-0.44). The c-statistic of the V-RESOLVE score was 0.76 (95% CI: 0.71 to 0.80), which was comparable to the c-statistic of the QCA-based RESOLVE score (0.77, 95% CI: 0.72 to 0.81) (p=0.74 for comparison). In simulations modelling inter-observer variability, the c-statistic of the V-RESOLVE score ranged from 0.65 to 0.77, all with p< 0.01.
Conclusions: The V-RESOLVE score performs similarly to the QCA-based RESOLVE score and can help stratify the risk of SB occlusion during bifurcation intervention.

• 出版日期2016-4
• 单位中国医学科学院北京协和医院; 中国医学科学院阜外医院