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Copyright ©The Author(s) 2022.
World J Cardiol. Jan 26, 2022; 14(1): 13-28
Published online Jan 26, 2022. doi: 10.4330/wjc.v14.i1.13
Table 1 Chronic total occlusion study results and clinical outcomes according to hierarchical levels of evidence-based medicine: Registries, meta-analyses, and randomized clinical trials
Studies
Patients (n)
CTO-PCI success
Follow-up
PCI success vs PCI failure
MACEDeath
RegistriesOPEN-CTO 2020 (12) (Hybrid approach)100090%1 yr3.4% vs 3.7%0.9% vs 0%
EXPERT-CTO 2019 (2) (New generation DES)25096.4%1 yr18.5% vs 24.4%NR
Valenti et al 2019 (3) (Elderly ≥ 75 yr)46072%5 yr9.6% vs 17%84% ± 3% vs 72% ± 6%
Sudhakar et al 2014 (4)1344370.6%2.65 yrNRHR 0.72, 95%CI: 0.62-0.83
MetanalysesChristakopoulos et al 2015 (5)2848671%3.11 yr29.1%6.4% vs 9.5%
Hoebers et al 2015 (6)1545971.7%1-10 yrNR10.4% vs 14.9%
Chenmin et al 2021 (7) (Elderly ≥ 75 yr)469370.4%-78.36%20 mo-5 yr16.8% vs 28.9%HR: 0.51, 95%CI: 0.34-0.77
RCTsDECISION CTO 2019 (8)83490.6%4 yr22.3% vs 22.4%3.6% vs 5.3%
EURO CTO 2018 (9)39686.6%1 yr5.2% vs 6.7%0.8% vs 0%
Table 2 Main scores for assessment of chronic total occlusions

J-CTO score
CL score
ORA score
PROGRESS score
RECHARGE score
EURO-CTO CASTLE score
Angiographic FeaturesProximal cap blunt1Proximal cap blunt1Ostial location1Proximal cap ambiguity1Proximal cap blunt1Proximal cap blunt1
Tortuosity > 45°1Lesion lenght > 20 mm1.5Collateral filling Rentrop 0-12Tortuosity1Tortuosity > 45°1Tortuosity > 45°1
Lenght > 20 mm1Calcification2Circumflex CTO1Lenght > 20 mm1Lenght > 20 mm1
Calcification1Non-LAD CTO1Absence of interventional collaterals1Calcification1Calcification1
Diseased distal landing zone1
Clinical featuresPrior CTO PCI failure1Previous MI1Age > 75 yr1Previous CABG on CTO target vessel1Previous CABG1
Previous CABG1.5Age > 70 yr1