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EURO CTO CLUB
Toulouse 2018
AL1 7 Fr, EBU 4.0 7 Fr
Ambiguous cap: 1
≥ 20 mm: 1
Calcium: 1
Re-try: 1
Bending: 0
JCTO Score 4
Male pt, 73-year-old
RCA-CTO found in 2009 - MVD
Stress-CMR: viability and ischemia, LVEF 40%
EURO CTO CLUB
Toulouse 2018
SEPTAL CC0
ATRIAL CC2
from LCx
EPICARDIAL CC1
from OM
EURO CTO CLUB
Toulouse 2018
Tazuna 1.25
to open stent cells
Caravel
In-stent take off
Corsair Pro does not cross
EURO CTO CLUB
Toulouse 2018
Tip injection Sion, Sion Blue Septal branch perforation
Tip Injection Sion Black for surfing Surfing unsuccessful
EURO CTO CLUB
Toulouse 2018
Suoh 03
Straight, good landing in PL
EURO CTO CLUB
Toulouse 2018
Caravel Prolapse Finecross ok
EURO CTO CLUB
Toulouse 2018
Step-up UB3 >>> Conquest Pro 12
Subintimal
Antegrade Gaia Third
Subintimal
Reverse CART
CTO uncrossable for retrograde Finecross
EURO CTO CLUB
Toulouse 2018
CTO uncrossable for antegrade Caravel
(no chance for anchoring)
Purpose: to cross with the antegrade Micro
EURO CTO CLUB
Toulouse 2018
Antegrade Caravel – Retrograde Finecross
Purpose: to cross with a low-profile balloon
CTO uncrossable for
Caravel Finecross Tazuna 1.25
EURO CTO CLUB
Toulouse 2018
BAM with Tazuna 1.25 Tornus 2.6 Fr
Unsuccessful Unsuccessful
EURO CTO CLUB
Toulouse 2018
Rotawire placement Burr 1.25
EURO CTO CLUB
Toulouse 2018
2.75 x 38 2.75 x 38 3.0 x 38Ultimaster
Remodeling
and calcific disease
Severe disease Ostial diseaseCalcific stenosis Subintimal tracking
EURO CTO CLUB
Toulouse 2018
EURO CTO CLUB
Toulouse 2018
Devices
Microcatheters have different structures, and therefore different
performances in a given setting
Techniques
A step-up workflow optimizes the use of a variety of technical options for
“uncrossable” CTO

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J CTO score ≥3

  • 1. EURO CTO CLUB Toulouse 2018 AL1 7 Fr, EBU 4.0 7 Fr Ambiguous cap: 1 ≥ 20 mm: 1 Calcium: 1 Re-try: 1 Bending: 0 JCTO Score 4 Male pt, 73-year-old RCA-CTO found in 2009 - MVD Stress-CMR: viability and ischemia, LVEF 40%
  • 2. EURO CTO CLUB Toulouse 2018 SEPTAL CC0 ATRIAL CC2 from LCx EPICARDIAL CC1 from OM
  • 3. EURO CTO CLUB Toulouse 2018 Tazuna 1.25 to open stent cells Caravel In-stent take off Corsair Pro does not cross
  • 4. EURO CTO CLUB Toulouse 2018 Tip injection Sion, Sion Blue Septal branch perforation Tip Injection Sion Black for surfing Surfing unsuccessful
  • 5. EURO CTO CLUB Toulouse 2018 Suoh 03 Straight, good landing in PL
  • 6. EURO CTO CLUB Toulouse 2018 Caravel Prolapse Finecross ok
  • 7. EURO CTO CLUB Toulouse 2018 Step-up UB3 >>> Conquest Pro 12 Subintimal Antegrade Gaia Third Subintimal Reverse CART CTO uncrossable for retrograde Finecross
  • 8. EURO CTO CLUB Toulouse 2018 CTO uncrossable for antegrade Caravel (no chance for anchoring) Purpose: to cross with the antegrade Micro
  • 9. EURO CTO CLUB Toulouse 2018 Antegrade Caravel – Retrograde Finecross Purpose: to cross with a low-profile balloon CTO uncrossable for Caravel Finecross Tazuna 1.25
  • 10. EURO CTO CLUB Toulouse 2018 BAM with Tazuna 1.25 Tornus 2.6 Fr Unsuccessful Unsuccessful
  • 11. EURO CTO CLUB Toulouse 2018 Rotawire placement Burr 1.25
  • 12. EURO CTO CLUB Toulouse 2018 2.75 x 38 2.75 x 38 3.0 x 38Ultimaster Remodeling and calcific disease Severe disease Ostial diseaseCalcific stenosis Subintimal tracking
  • 14. EURO CTO CLUB Toulouse 2018 Devices Microcatheters have different structures, and therefore different performances in a given setting Techniques A step-up workflow optimizes the use of a variety of technical options for “uncrossable” CTO