Scores and algorithms in CTO PCI: “PROGRESS” or an exercise in futility?

Chronic total occlusions (CTO) are a common anatomical entity in complex coronary artery disease. Treatment options over the last two decades have been revolutionised by an evolution in techniques and technology. Treatment algorithms intended to guide new operators through structured procedural planning and practice have been created. Many of these proposed algorithms reflect local practices around the globe. Global guiding principles and a global algorithm1 have been published very recently, which is indicative that practices are gradually becoming standardised and harmonised globally. Not all CTO scores are the same. The J-CTO score was developed in 2011 to predict the possibility of ...