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Updated: Jul 24, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

459

Assessment of the ERCTO Score for Predicting Success in Retrograde Chronic Total Occlusion Percutaneous Coronary

Athanasios Rempakos, Bahadir Simsek, Spyridon Kostantinis

  • 1Minneapolis Heart Institute, 920 E 28th Street #300, Minneapolis, MN 55407. esbrilakis@gmail.com.

The Journal of Invasive Cardiology
|July 6, 2023
PubMed

Insights

The ERCTO Retrograde score offers modest prediction for technical success in retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI). This tool evaluates factors like calcification and operator volume to guide complex PCI procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • The retrograde strategy is frequently employed in complex chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
  • The ERCTO Retrograde score was developed to predict technical success in these procedures.
  • The score assesses five key parameters: calcification, distal opacification, proximal tortuosity, collateral connection, and operator volume.

Purpose of the Study:

  • To evaluate the predictive performance of the ERCTO Retrograde score for technical success in retrograde CTO PCI.
  • To assess the score's utility in guiding complex interventional cardiology procedures.

Main Methods:

  • Data from 2341 patients undergoing retrograde CTO PCI between 2013 and 2023 were analyzed from the PROGRESS-CTO registry.
  • The ERCTO Retrograde score's association with technical success was examined.
  • The study included both primary and secondary retrograde CTO PCI strategies.

Main Results:

  • Technical success was achieved in 77.3% of cases.
  • The ERCTO Retrograde score demonstrated a positive association with procedural success.
  • The score's c-statistic was 0.636 for all cases and 0.651 for primary retrograde cases, indicating modest predictive capacity.

Conclusions:

  • The ERCTO Retrograde score provides a modest yet valuable tool for predicting technical success in retrograde CTO PCI.
  • The findings support the score's utility in planning and executing complex PCI procedures.
Abstract

Keywords:
intravascular imagingpercutaneous coronary interventionchronic total occlusionsintravascular ultrasound

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