PCI Risk Assessment for Outcome After PCI - Medical Algorithm

Description

Ellis et al developed a new risk model to describe outcome after percutaneous coronary intervention (PCI). This model uses lesion characteristics seen on angiography during the procedure. The authors are from the Cleveland Clinic.

Moderately strong correlates (as defined in Table 1, page 1972):

(1) length in mm

(2) lumen irregularity (irregularly shaped or sawtooth lumen edges)

(3) filling defect (any angiographic lucency with contrast surrounding at least 3 sides)

(4) calcification >= Grade 2 and angulated >= 45°

(5) eccentric

(6) severity of calcification in target vessel

(7) age of saphenous vein graft (SVG)

Parameter	Finding	Points
length	< 10 mm	0
	>= 10 mm	1
lumen irregularity	absent	0
	present	1
filling defect	small to moderate	0
	large	1
calcified and angulated >= 45°	absent	0
	present	1
eccentric lesion	absent	0
	present	1
calcification	none, mild, moderate	0
	severe	1
age of saphenous vein graft	< 10 years	0
	>= 10 years	1

points for moderately strong correlates =

= SUM(points for all 7 parameters)

Strongest correlates:

(1) chronicity of total occlusion (total occlusion is TIMI grade ) or 1; chronic occlusion is indicated by either a known duration >= 3 months or bridging collaterals)

(2) status of saphenous vein graft (degenerated if more than 50% of length shows luminal irregularities, filling defect, gross irregularity or staining)

Parameter	Finding	Points
total occlusion	chronic	0
	non-chronic	1
status of saphenous vein graft	non-degnerated	0
	degenerated	1

points for strongest correlates =

= SUM(points for both parameters)

Interpretation:

• minimum number of moderately strong and strongest correlates: 0

• maximum number of moderately strong correlates: 7

• maximum number of strongest correlates: 2

Strongest Correlates	Moderately Strong Correlates	Risk Group	Risk Class
1 or 2	NA	highest	IV
0	3 - 7	high	III
0	1 or 2	moderate	II
0	0	low	I

Risk Group	Complications
highest	2.1%
high	3.4%
moderate	8.2%
low	12.7%

where:

• Complications = death, emergency CABG, large AMI (elevation CK >= 3 times normal)

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Description

Specialty

Objective

ICD-10

Risk Assessment Scheme of Ellis et al for Outcome After Percutaneous Coronary Intervention (PCI)

Purpose: To predict adverse outcomes after percutaneous coronary intervention (PCI) using the risk scheme of Ellis et al.

Description

Specialty

Objective

ICD-10