Association between J‐CTO score and long‐term target lesion revascularization rate after successful chronic total coronary occlusion angioplasty (from the J‐CTO Registry)

Abstract

Objectives: The aim of this study was to evaluate the impact of the J-CTO score on long-term target lesion revascularization (TLR) after successful native chronic total occlusion (CTO)percutaneous coronary intervention (PCI).Background: We previously reported that the J-CTO score could be used to stratify the lesion complexity and procedural success rate in CTO lesions.Methods: We evaluated the prognostic significance of a high J-CTO score for long-term TLR rate in the J-CTO Registry.Results: In the 425 lesions of 408 patients who underwent successful CTO-PCI during a median follow-up of 63.0 (interquartile range: 21.2-72.9) months in the J-CTO Registry, the cumulative incidence of TLR of lesions with a J-CTO score ≥ 2 (n = 216) was significantly higher than in those with a J-CTO score ≤ 1 (n = 209) (27.0 versus 19.4% at 5 years, respectively, P = 0.04).Among 323 lesions of 309 patients with a complete 5-year follow-up, the rate of TLR was 28% (n = 91). A J-CTO score ≥ 2 was independently associated with a higher risk of TLR (odds ratio,

Incidence and characteristics of ventricular tachycardia in patients after percutaneous coronary revascularization of chronic total occlusions

“…To simplify the analysis, three levels of severity were distinguished (easy with J-CTO score = 0; intermediate with J-CTO score = 1; difficult with J-CTO score�2) in analogy to similar recent publications. [20,21] CTOs were defined as CTOs of infarct-related arteries depending on the medical history for myocardial infarction, the presence of pathological Q waves in the corresponding coronary territory or matching scar in cardiac magnetic resonance imaging. After each procedure, vital signs were monitored for at least 6 hours or longer in cases of new or recurrent symptoms.…”

Predictors for adverse outcomes of patients with recanalized chronic total occlusion lesion

“…However, more interestingly, non‐LAD CTO was more likely to receive revascularization than LAD after recanalization. In most cases, non‐LAD CTO lesion was more difficult to be recanalized than LAD 13 . Additionally, side branches of non‐LAD vessels were also less than LAD.…”

“…In present study, we found that high J‐CTO score was unrelated to the occurrence of composite cardiovascular event during follow‐up, but it was associated with increased TLR and TVR event. Lesions with high J‐CTO score often required subintimal tracking and long stent implantation, 13,15 both of which had the potential to lead to target lesion failure 14,16,20 …”

Application of the Hybrid Approach to Chronic Total Coronary Occlusion Percutaneous Coronary Intervention

“…The first CTO PCI score was the J-CTO score (Multicenter CTO Registry of Japan) that was developed to estimate the likelihood of successful guidewire crossing within 30 minutes based on 5 criteria (intralesional >45° bend, length >20 mm, calcification, blunt stump, and previously failed attempt) (38). The J-CTO score has been validated in other CTO PCI cohorts (39) and is also associated with 1-year and 5-year clinical outcomes (40,41). is currently the only one that also takis into account on operators' experience with CTO PCI (47).…”

“…Ki kell emelnünk ugyanakkor, hogy subintimalis pozíció esetén a legjobb eredményt a dedikált anterográd disszekció re-entry technika alkalmazása adja erre specializált eszközökkel (CrossBoss mikrokatéter, Stingray ballon [mindketveszéllyel jár, hogy nagy subintimalis haematomát képezünk, ezután már egyre nehezebb a valódi lumenbe jutás. A hosszú szakaszon subintimalis stentelés pedig magas restenosis és reokklúziós rátát okozhat (41,42). A dedikált re-entry eszközökön kívül is lehetséges azonban a distalis valódi lumenbe visszajutás a követ-Paralleldrótozási technika (43) - (7. ábra, B panel) raluminalis vezetését azáltal, hogy a helyben hagyott meggátolja hogy a második drót ugyanazt a fals utat kö--jékozódást.…”