Table 1. Currently available scoring systems for CTO PCI.
| Score variables | J-CTO score (3) | CL score (4) | PROGRESS-CTO score (5) | ORA score (6) | Chai et al. (7) | Wilson et al. (8) | Liu et al. (9) | CT-RECTOR score* (10) | Ito et al.* (11) |
|---|---|---|---|---|---|---|---|---|---|
| Number of cases (n) | 494 | 1,657 | 781 | 1,073 | 228 | 1,156 | 728 | 240 | 263 |
| Endpoint | GW crossing <30 min | Technical success | Technical success | Technical success | Technical success-retrograde | Technical success | CIN | GW crossing ≤30 min | MACE during follow-up‡ |
| Age (years) | – | – | – | + (≥75) | – | + (>65) | + (≥75) | – | – |
| Prior CABG | – | + | – | – | – | + | – | – | – |
| Prior failure | + | – | – | – | – | – | – | + | – |
| Proximal cap | + (blunt) | + (blunt) | + (ambiguous) | + (ostial) | – | + | – | + (blunt) | – |
| Tortuosity | + (>45º in lesion) | – | + (moderate†, proximal) | – | – | + | – | + | – |
| Calcification | + | + (severe) | – | – | – | + | – | + (severe) | + (severe) |
| Lesion length | + (≥20 mm) | + (≥20 mm) | – | – | – | + | – | – | + (>25.4 mm) |
| Target vessel | – | + (non-LAD) | + (LCX) | – | – | – | – | – | – |
| Collateral quality | – | – | + (lack of interventional) | + (Rentrop <2) | + (Werner, tortuous) | – | – | – | – |
| Other | – | Prior myocardial infarction | – | – | Distal segment diameter | BMI >30; non-proximal location | LVEF <40%; SCr >1.5 mg/dL | Multiple occlusions; duration ≥12 months | Minimal vessel area <11.9 mm2 |
*, computed tomography angiography based; †, moderate tortuosity defined as 2 bends >70° or 1 bend >90° proximal to the lesion; ‡, defined as cardiac death, myocardial infarction, stent thrombosis or target lesion revascularization at median 4.0 years follow-up; +, variable included in score. CTO, chronic total occlusion; PCI, percutaneous coronary intervention; J-CTO, multicenter CTO registry in Japan; CL, clinical and lesion-related; PROGRESS CTO, Prospective Global Registry For The Study of Chronic Total Occlusion Intervention; CT-RECTOR, Computed Tomography Registry of Chronic Total Occlusion Revascularization; ORA, ostial location, Rentrop grade <2, age ≥75 years; BMI, body mass index; CABG, coronary artery bypass grafting; CIN, contrast induced nephropathy; GW, guidewire; LAD, left anterior descending artery; LCX, circumflex artery; LVEF, left ventricular ejection fraction; MACE, major adverse cardiovascular events; SCr, serum creatinine.