Morino et al reported the J-CTO score for evaluating a complete occlusion of the native coronary artery during a percutaneous coronary intervention (PCI). The authors are from multiple institutions in Japan and Redwood City in California participating in the Multicenter CTO Registry of Japan.
Patient selection: chronic total occlusion (CTO) of a native coronary artery
Outcome: passage of a guidewire across the occlusion within 30 minutes
Parameters:
(1) lesion previously failed
(2) type (appearance)
(3) bending
(4) calcifications
(5) occlusion length in millimeters
Parameter |
Finding |
Points |
lesion previously failed |
no |
0 |
|
yes |
1 |
type |
blunt stump |
1 |
|
other |
0 |
bending |
no |
0 |
|
yes |
1 |
calcifications |
no |
0 |
|
yes |
1 |
occlusion length |
< 20 mm |
0 |
|
>= 20 mm |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The difficulty of the procedure increases as the score increases.
Total Score |
Description |
Probability of Crossing |
0 |
easy |
88% |
1 |
intermediate |
67% |
2 |
difficult |
42% |
>= 3 |
very difficult |
<= 10% |
Performance:
• The area under the ROC was 0.82 for the derivation set and 0.76 for the validation set.
Specialty: Cardiology