Prediction of Successful Guidewire Crossing of Below-the Knee Chronic Total Occlusions using a Japanese Scoring System

Abstract Objective To develop a scoring system which can adequately predict a successful guidewire crossing of below-the-knee (BTK) chronic total occlusions (CTOs) in angiographic evaluation. Methods A retrospective, multicenter, non-randomized study examined 448 consecutive BTK CTOs in 299 patients treated with endovascular therapy in 7 Japanese medical centers from April 2012 to April 2020. The cohort was classified into 2 groups: a successful guidewire crossing group (S-GC) and a failed guidewire crossing group (F-GC). Results The final logistic regression model created by a backward stepwise multivariate logistic regression model included 5 variables: "No outflow of the target vessel”, “CTO length ≥ 200mm”, “Reference vessel diameter (RVD) Conclusion The J-BTK CTO score predicts the probability of a successful guidewire crossing of BTK CTOs and stratifies the difficulty of EVT for BTK CTOs in angiographic evaluation.