J-CTO score for prediction of wire crossing in CTO

J-CTO score for prediction of wire crossing in CTO

J-CTO score for prediction of wire crossing in chronic total occlusion of native coronary arteries in 30 minutes is from the multicenter CTO registry of Japan.

The five points considered for the score were calcification, bends, blunt stump, occlusion length of more than 20 millimeters and a previously failed attempt. All these were considered as independent predictors of difficulty and delay in crossing the CTO. The difficulty was graded into easy, intermediate, difficult and very difficult groups depending on the J-CTO score. Each predictor was given one point and total score calculated.

Easy group had a score of zero. Very difficult had a J-CTO score of three or more. Intermediate group had a score of one and the difficult group a score of two [1].

A meta-analysis of 24 studies was published in December 2022. Authors of the meta-analysis concluded that J-CTO score has useful discrimination in predicting 30-min wire crossing while performing moderately for technical success [2].

References

1. Yoshihiro Morino, Mitsuru Abe, Takeshi Morimoto, Takeshi Kimura, Yasuhiko Hayashi, Toshiya Muramatsu, Masahiko Ochiai, Yuichi Noguchi, Kenichi Kato, Yoshisato Shibata, Yoshikazu Hiasa, Osamu Doi, Takehiro Yamashita, Tomoaki Hinohara, Hiroyuki Tanaka, Kazuaki Mitsudo, J-CTO Registry Investigators. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: the J-CTO (Multicenter CTO Registry in Japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc Interv. 2011;4:213-221.
2. Zuo W, Lin J, Sun R, Su Y, Ma G. Performance of the J-CTO score versus other risk scores for predicting procedural difficulty in coronary chronic total occlusion interventions. Ann Med. 2022 Dec;54(1):3117-3128. doi: 10.1080/07853890.2022.2141466. PMID: 36322535; PMCID: PMC9635461.