Abe M, et al. - Researchers assessed the influence of the J-CTO score on long-term target lesion revascularization (TLR) following successful native chronic total occlusion (CTO)-percutaneous coronary intervention (PCI) in the J-CTO Registry. They assessed 425 lesions of 408 patients who underwent successful CTO-PCI. These subjects were followed-up for a median duration of 63.0 (interquartile range: 21.2–72.9) months. They reported a significantly higher cumulative incidence of TLR of lesions with a J-CTO score ≥ 2 (n = 216) vs in those with a J-CTO score ≤ 1 (n = 209) (27.0 vs 19.4% at 5 years, respectively). They reported 28% (n = 91) rate of TLR among 323 lesions of 309 patients with a complete 5-year follow-up. Findings revealed an independent association of a J-CTO score ≥ 2 with a higher risk of TLR even after adjustment for clinically relevant baseline factors. Overall, a higher 5-year risk of TLR was reported for patients with high J-CTO score lesions.