Accuracy of J-CTO Score Derived From Computed Tomography Versus Angiography to Predict Successful Percutaneous Coronary Intervention

Abstract

The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography.

A computed tomography algorithm for crossing coronary chronic total occlusions: riding on the wave of the proximal cap and distal vessel segment

“…1). Notably, the trials on CTA-derived scoring systems comprised European, Japanese, and Chinese populations enrolled between 2007 and 2016, and predominantly focused on antegrade wiring strategies [25,27,29,30]. Hence, the clinical applicability of CT scores for prediction of CTO PCI success rates using retrograde wiring and dissection and re-entry strategies is largely unknown.…”

“…Notably, the CT-RECTOR score was externally validated in a Chinese population as a more accurate prediction rule for 30-min guidewire crossing and final procedural success rate as compared with the angiographic J-CTO (Multicenter Chronic Total Occlusion Registry of Japan) score [31]. Subsequently, two trials explored the predictive ability of the J-CTO score derived from CTA (the so-called J-CTOCT score) [29,30]. Interestingly, while in one study the non-invasive J-CTO score determined by CTA yielded a similar predictive value for 30-min guidewire crossing as compared with the angiographic J-CTO score [29], the other study demonstrated significantly higher discriminating accuracy of the J-CTOCT score than that of the angiography-based J-CTO score [30].…”

“…Subsequently, two trials explored the predictive ability of the J-CTO score derived from CTA (the so-called J-CTOCT score) [29,30]. Interestingly, while in one study the non-invasive J-CTO score determined by CTA yielded a similar predictive value for 30-min guidewire crossing as compared with the angiographic J-CTO score [29], the other study demonstrated significantly higher discriminating accuracy of the J-CTOCT score than that of the angiography-based J-CTO score [30]. Noteworthy is that the J-CTO scores determined by coronary CTA and invasive angiography differ in the amount of surveyed calcification-while on CTA calcification must involve >50% of the vessel CSA, invasive angiography stratifies the presence or absence of calcification only.…”

CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

“…Coronary CT angiography (CCTA), a non-invasive imaging technique, can characterize the features of the CTO segment, which is a notable advantage over CA for the assessment of longer and more tortuous CTO lesions, as well as segments distal to a CTO lesion [11]. Moreover, it can provide prognostic information beyond CA [12][13][14][15][16][17], and it has been investigated as an alternative pre-procedural imaging method for CTO-PCI [18]. However, it is unclear whether the RECHARGE score can be calculated using CCTA data.…”

Incidence and in-hospital outcomes of single-vessel coronary chronic total occlusion treated with percutaneous coronary intervention

“…Further, success rates for coronary CTOPCI procedures in our study cohort cannot be ascertained for inpatient hospitalizations as well. Severity of the CTO lesion as measured by SYNTAX or J-CTO scoring system, both of which are good predictors of procedural success,[38] could not be determined in our study cohort. Finally, the NIS data are available for in-hospital stay only; as such differences in long term outcomes for patients undergoing single-vessel coronary CTO-PCI for stable CAD could not be assessed.…”