12:10 CASE 10 - Meyer-Gessner
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This document discusses approaches for a complex coronary artery bypass graft (CABG) case involving both antegrade and retrograde wiring. It presents several failure scenarios and asks for the next step. For the initial approach, retrograde wiring through the distal cap is preferred, but antegrade or dissection/reentry are alternatives. If retrograde wiring fails, options include using a dedicated microcatheter retrograde or continuing antegrade with a different guidewire or IVUS. If antegrade wiring fails, retrograde or dissection/reentry are considered. For ischemia threatening closure, completing dissection/reentry is suggested. The key learning points emphasize that guidewires can help or hinder, arterial grafts are fragile,
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1) The document discusses changes in distal vessels after successful recanalization of chronic total occlusions (CTOs), including vasomotion changes and vessel remodeling seen on intravascular ultrasound (IVUS).
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2. The need for hemodynamic support, particularly when using retrograde approaches.
3. Tips for procedural success including using the easiest CTO first and considering staged procedures.
4. The debate around complete vs. incomplete revascularization and factors to consider.
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This document discusses strategies for chronic total occlusion percutaneous coronary intervention (CTO PCI), specifically the criteria for choosing an antegrade versus retrograde approach. The key points are:
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2) Exceptions include when targeting ostial lesions or bifurcations where antegrade wiring risks side branch loss.
3) The decision of when to stop antegrade wiring and switch to retrograde depends on the specific lesion characteristics and may require balancing wire passage risks with procedural time.
08:05 Escaned - Final cto training for all
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Nicolaus Reifart – Antegrade Skills
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___________________________________________
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Francesco Burzotta: Wrap up Gemelli Cases
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1) The document describes a prospective study assessing the safety and performance of bioresorbable vascular scaffolds (BVS) in percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs).
2) 35 patients with CTOs underwent PCI with BVS implantation and were followed clinically and with imaging for 6-8 months.
3) Preliminary results found excellent mid-term patency and safety with no deaths, myocardial infarctions, or scaffold thromboses at 6-8 months follow-up.
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This procedure report describes a simple retrograde CTO procedure that took 170 minutes with 58 minutes of fluoroscopy time. The key learnings are that retrograde CTO can be effective, predictable and safe if approached systematically by using the first procedure to prepare the CTO for treatment, such as with kissing techniques on septal or collateral branches. While the procedure was long, it was successful using minimal contrast and radiation by taking the time needed.
16:05 Bufe - Learning to stop and to stage CTO PCI
1) The document discusses strategies for percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs), including staged procedures and when to stop a procedure.
2) It notes that in cases of failed antegrade PCI, patients should be referred to a CTO specialist center for a second attempt, either immediately with a retrograde approach or in a staged procedure later.
3) Successful CTO recanalization rates have increased in recent years with more use of retrograde approaches, either primarily or after failed antegrade attempts. However, radiation exposure, contrast volume, and complications should be considered in determining when to stop a procedure.
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This document discusses identifying patients that may benefit from percutaneous coronary intervention (PCI) to treat chronic total occlusions (CTOs). It notes that patients with clinical symptoms like angina or heart failure, or those with viable myocardium, are likely to benefit from CTO-PCI. The document also examines factors like the SYNTAX score and completeness of revascularization that influence whether PCI or coronary artery bypass grafting (CABG) is a better option for treating multi-vessel disease when one of the vessels is a CTO. It emphasizes the importance of assessing a patient's individual clinical presentation and ischemia to determine if CTO-PCI may provide symptom relief.
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This document provides an overview of retrograde techniques for recanalizing chronic total occlusions (CTOs). It discusses the history and evolution of retrograde techniques, including septal collateral crossing and dilatation. Key steps in the retrograde approach like wire escalation, dissection and re-entry are outlined. Case examples demonstrate the retrograde procedure in detail. Consensus recommendations emphasize the importance of operator experience before performing retrograde CTO PCI independently. Required lab set-up and equipment are also reviewed.
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This document discusses techniques for using double lumen catheters in CTO-PCI procedures. It describes the limitations of classic reverse CART techniques and recommends using GAIA wires for retrograde wiring with careful antegrade preparation. For short CTOs, direct retrograde wiring can work well with GAIA with or without IVUS. But for long CTOs with unknown vessel trajectory, careful antegrade preparation is needed to avoid perforation, and alternative non-tapered wires may be preferable to GAIA for staying inside the vessel. The document provides tips for reverse CART including doing antegrade ballooning close to the CTO end, being careful of antegrade wire position, and not using retrograde GAIA if
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This document summarizes a presentation on CTO PCI in patients with multiple vessel disease and low left ventricular ejection fraction (LVEF). The presentation discusses:
1. The importance of assessing viability and ischemia before revascularization.
2. The need for hemodynamic support, particularly when using retrograde approaches.
3. Tips for procedural success including using the easiest CTO first and considering staged procedures.
4. The debate around complete vs. incomplete revascularization and factors to consider.
5. The importance of clinical and angiographic follow-up given the risk of restenosis in this complex patient group.
Saturday 1615 – louvard – cto age
This study assessed the outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) in elderly patients aged 75 years and older compared to younger patients. The study found that CTO PCI success rates were similar between those aged 75+ and younger. While major adverse cardiac event rates were higher in the elderly, successful revascularization was associated with reduced MACE and cardiac mortality at 5-year follow-up in both age groups. The conclusion is that age alone should not determine PCI eligibility and that CTO PCI can provide benefits in elderly patients similar to younger patients when clinically appropriate.
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This document discusses strategies for chronic total occlusion percutaneous coronary intervention (CTO PCI), specifically the criteria for choosing an antegrade versus retrograde approach. The key points are:
1) An antegrade wire should generally be placed first before attempting a retrograde approach to help connect the wires and reduce retrograde dwelling time.
2) Exceptions include when targeting ostial lesions or bifurcations where antegrade wiring risks side branch loss.
3) The decision of when to stop antegrade wiring and switch to retrograde depends on the specific lesion characteristics and may require balancing wire passage risks with procedural time.
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This document discusses the need for more operators to be trained in treating chronic total occlusions (CTOs) with percutaneous coronary intervention (PCI). It notes that while success rates for standard PCI procedures are now over 95% for most operators, success rates for CTO PCI have remained around 50% for untrained operators but are 80-90% for trained operators. It argues that low CTO PCI success rates have led to undertreatment of patients with clinical indications for CTO revascularization. Expert clubs have helped standardize CTO PCI approaches and increased success rates to around 80-90%, but adoption of these approaches among general interventionalists remains low due to obstacles like established habits and perceptions of CTO PCI as requiring specialized skills
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Carlo Maccia - The CTO dose registry: a tool for optimizing patient radiation...
Sergey Furkalo - Retrograde LAD CTO recanalisation in patient with critical L...
Sergey Furkalo - Retrograde LAD CTO recanalisation in patient with critical L...
16:05 Bufe - Learning to stop and to stage CTO PCI
16:05 Bufe - Learning to stop and to stage CTO PCI
10:50 Werner - Identifying the patients that benefit from CTO PCI
10:50 Werner - Identifying the patients that benefit from CTO PCI
Georgios Sianos - RETROGRADE STEP BY STEP APPROACH
Georgios Sianos - RETROGRADE STEP BY STEP APPROACH
Alfredo R. Galassi - How to deal with very LVEF: the last remaining option to...
Alfredo R. Galassi - How to deal with very LVEF: the last remaining option to...
More from Euro CTO Club
15th Experts Live CTO - Carlo Di Mario: Conclusions
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Francesco Burzotta: Wrap up Gemelli Cases
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Shunsuke Matsuno: Progress in dedicated novel CTO material
Live Cases from Rome and Florence
From San Camillo Hospital, Rome
Operators:
Gabriele Gasparini (Milan),
Roberto Garbo (Turin),
Rocco Stio (Rome)
From Careggi University Hospital, Florence
Operators:
Gerald Werner (Darmstadt - D),
Jaroslaw Wójcik (Lublin - PL),
Carlo Di Mario (Florence)
Flash Highlight
Progress in dedicated novel CTO material
Shunsuke Matsuno (Tokyo - J)
___________________________________________
PLENARY SESSION
Live Cases from Rome and Florence + Flash Highlight
Auditorium Zubin Mehta - Saturday 11:30 - 13:00
Coordinator:
Roberto Garbo (Turin)
Chairperson:
Alexander Bufe (Krepeld - D)
Discussants:
Claudia Cosgrove (London - UK),
Gorgulu Sevket (Istanbul - TR)
Challengers:
Pierfrancesco Agostoni (Antwerp - B),
John Davies (Basildon - UK)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Jonathan Hill: Role of mechanica support in CTO recanalization
10:42
Role of mechanica support in CTO recanalization
Jonathan Hill (London - UK)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Gregor Leibundgut: Role of DEB in CTO-PCI
10:35 Role of DEB in CTO-PCI
Gregor Leibundgut (Basel - CH)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Leszek Bryniarski: Mechanical protection in CTO PCI: the Krakow experience
10:28
Mechanical protection in CTO PCI: the Krakow experience
Leszek Bryniarski
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Sunsuke Matsuno: Intracoronary imaging guidance in CTO practice
AUDITORIUM ZUBIN MEHTA
09/09/2023 10:00 - 11:10
PARALLEL SESSION - CHALLENGES AND OPPORTUNITIES IN CTO RECANALIZATION
15th Experts Live CTO: Mohamed Ayoub: Aorto-ostial CTO
10:07
Aorto-ostial CTO
Mohamed Ayoub (Bad Oeynhausen - D)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
15th Experts Live CTO - Claudia Cosgrove: Calcium and CTO
10:14
Calcium and CTO
Claudia Cosgrove (London - UK)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Gregor Leibundgut Update on microcatheter options and selection
Live Cases from Florence and Rome
From Tor Vergata Hospital, Rome
Operators:
Andrea Gagnor (Turin),
Mohaned Egred (Newcastle - UK),
Daniela Benedetto (Rome)
From Careggi University Hospital, Florence
Operators:
Masahisa Yamane (Tokyo - J),
Stelios Pyxaras (Furth - D),
Carlo Di Mario (Florence)
Flash Highlights
8:30
Update on microcatheter options and selection
Gregor Leibundgut (Basel - CH)
___________________________________________
PLENARY SESSION
Live Cases from Florence and Rome + Flash Highlights
Auditorium Zubin Mehta - Saturday 8:30 - 10:00
Coordinator:
Roberto Garbo (Turin)
Chairpersons:
Heinz Joachim Büttner (Bad Krozingen - D),
Roberto Diletti (Rotterdam - NL)
Discussants:
Michael Behnes (Mannheim - D),
Giacomo Boccuzzi (Turin),
Alexander Bufe (Krefeld - D),
Salvatore Colangelo (Turin)
Challengers:
Paul Knaapen (Amsterdam - NL),
Gioel Gabrio Secco (Alessandria)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Francesco Burzotta: Tips & tricks on radial CTO-PCI
Live Cases from Florence and Rome
From Tor Vergata Hospital, Rome
Operators:
Andrea Gagnor (Turin),
Mohaned Egred (Newcastle - UK),
Daniela Benedetto (Rome)
From Careggi University Hospital, Florence
Operators:
Masahisa Yamane (Tokyo - J),
Stelios Pyxaras (Furth - D),
Carlo Di Mario (Florence)
Flash Highlights
8:30
Tips & tricks on radial CTO-PCI
Francesco Burzotta (Rome)
___________________________________________
PLENARY SESSION
Live Cases from Florence and Rome + Flash Highlights
Auditorium Zubin Mehta - Saturday 8:30 - 10:00
Coordinator:
Roberto Garbo (Turin)
Chairpersons:
Heinz Joachim Büttner (Bad Krozingen - D),
Roberto Diletti (Rotterdam - NL)
Discussants:
Michael Behnes (Mannheim - D),
Giacomo Boccuzzi (Turin),
Alexander Bufe (Krefeld - D),
Salvatore Colangelo (Turin)
Challengers:
Paul Knaapen (Amsterdam - NL),
Gioel Gabrio Secco (Alessandria)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Kambis Mashayekhi: EuroCTO Consensus on treatment of Calcified CTO lesion Eur...
AUDITORIUM ZUBIN MEHTA
08/09/2023 04:30 - 05:20
PLENARY SESSION - INTERVENTIONAL CTO & CHIP RESEARCH Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Emmanouil S. Brilakis - CTO PCI Outcome associated with poor quality of the d...
16:53
CTO PCI Outcome associated with poor quality of the distal target vessel
Emmanouil Brilakis (Minneapolis - USA)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Mario Iannaccone - 2 EuroCTO Consensus on Guide Catheter Extensions JACC Card...
16:33
EuroCTO Consensus on Guide Catheter Extensions JACC Cardiovasc Interventions
Mario Iannaccone (Turin)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Javier Escaned: 3 Low contrast complex and CTO PCI
Flash Highlights
15:00
3 Low contrast complex and CTO PCI
Javier Escaned (Madrid - Spain)
___________________________________________
PARALLEL SESSION
Live Cases from Rome + Flash Highlights
Auditorium Zubin Mehta - Friday 15:00 - 16:30
Coordinator:
Andrea Gagnor (Turin)
Chairpersons:
Roberto Diletti (Rotterdam - NL),
Bernward Lauer (Jena - D)
Discussants:
Alessio Gaetano La Manna (Catania),
Eugenio Stabile (Potenza)
Challengers:
Paul Knaapen (Amsterdam - NL),
Alessio Mattesini (Florence)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Giuseppe Tarantini: Protect IV and PROTECT-Europe trial
11:35
Protect IV and PROTECT-Europe trial
Giuseppe Tarantini (Padua)
_____________________________________________
PARALLEL SESSION
Cto & Chip Regitries & Trials
Auditorium Zubin Mehta - Friday 11:00 - 12:00
Chairpersons:
Paul Knaapen (Amsterdam - NL),
Gennaro Sardella (Rome)
Discussants:
Björn Billmann (Wolfenbuettel - D),
Laurent Drogul (Nice - F),
Sergey Furkalo (Kiev - UA),
Maciej Lesiak (Poznan - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Paul Knaapen: The PROCTOR randomized trial
11:28
The PROCTOR randomized trial
Paul Knaapen (Amsterdam - NL)
_____________________________________________
PARALLEL SESSION
Cto & Chip Regitries & Trials
Auditorium Zubin Mehta - Friday 11:00 - 12:00
Chairpersons:
Paul Knaapen (Amsterdam - NL),
Gennaro Sardella (Rome)
Discussants:
Björn Billmann (Wolfenbuettel - D),
Laurent Drogul (Nice - F),
Sergey Furkalo (Kiev - UA),
Maciej Lesiak (Poznan - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
John Davies: Update on the ORBITA - CTO trial
11:21
Update on the ORBITA - CTO trial
John Davies (Basildon - UK)
_____________________________________________
PARALLEL SESSION
Cto & Chip Regitries & Trials
Auditorium Zubin Mehta - Friday 11:00 - 12:00
Chairpersons:
Paul Knaapen (Amsterdam - NL),
Gennaro Sardella (Rome)
Discussants:
Björn Billmann (Wolfenbuettel - D),
Laurent Drogul (Nice - F),
Sergey Furkalo (Kiev - UA),
Maciej Lesiak (Poznan - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Masahisa Yamane: The Complex CTO Japanese Registry
11:14
The Complex CTO Japanese Registry
Masahisa Yamane (Tokyo - J)
_____________________________________________
PARALLEL SESSION
Cto & Chip Regitries & Trials
Auditorium Zubin Mehta - Friday 11:00 - 12:00
Chairpersons:
Paul Knaapen (Amsterdam - NL),
Gennaro Sardella (Rome)
Discussants:
Björn Billmann (Wolfenbuettel - D),
Laurent Drogul (Nice - F),
Sergey Furkalo (Kiev - UA),
Maciej Lesiak (Poznan - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Kambis Mashayekhi: Trends and spin-offs from the EuroCTO Registry
11:00
Trends and spin-offs from the EuroCTO Registry
Kambis Mashayekhi (Lahr - D)
_____________________________________________
PARALLEL SESSION
Cto & Chip Regitries & Trials
Auditorium Zubin Mehta - Friday 11:00 - 12:00
Chairpersons:
Paul Knaapen (Amsterdam - NL),
Gennaro Sardella (Rome)
Discussants:
Björn Billmann (Wolfenbuettel - D),
Laurent Drogul (Nice - F),
Sergey Furkalo (Kiev - UA),
Maciej Lesiak (Poznan - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
More from Euro CTO Club (20)
15th Experts Live CTO - Carlo Di Mario: Conclusions
15th Experts Live CTO - Carlo Di Mario: Conclusions
Shunsuke Matsuno: Progress in dedicated novel CTO material
Shunsuke Matsuno: Progress in dedicated novel CTO material
Jonathan Hill: Role of mechanica support in CTO recanalization
Jonathan Hill: Role of mechanica support in CTO recanalization
Leszek Bryniarski: Mechanical protection in CTO PCI: the Krakow experience
Leszek Bryniarski: Mechanical protection in CTO PCI: the Krakow experience
Sunsuke Matsuno: Intracoronary imaging guidance in CTO practice
Sunsuke Matsuno: Intracoronary imaging guidance in CTO practice
15th Experts Live CTO: Mohamed Ayoub: Aorto-ostial CTO
15th Experts Live CTO: Mohamed Ayoub: Aorto-ostial CTO
15th Experts Live CTO - Claudia Cosgrove: Calcium and CTO
15th Experts Live CTO - Claudia Cosgrove: Calcium and CTO
Gregor Leibundgut Update on microcatheter options and selection
Gregor Leibundgut Update on microcatheter options and selection
Francesco Burzotta: Tips & tricks on radial CTO-PCI
Francesco Burzotta: Tips & tricks on radial CTO-PCI
Kambis Mashayekhi: EuroCTO Consensus on treatment of Calcified CTO lesion Eur...
Kambis Mashayekhi: EuroCTO Consensus on treatment of Calcified CTO lesion Eur...
Emmanouil S. Brilakis - CTO PCI Outcome associated with poor quality of the d...
Emmanouil S. Brilakis - CTO PCI Outcome associated with poor quality of the d...
Mario Iannaccone - 2 EuroCTO Consensus on Guide Catheter Extensions JACC Card...
Mario Iannaccone - 2 EuroCTO Consensus on Guide Catheter Extensions JACC Card...
Javier Escaned: 3 Low contrast complex and CTO PCI
Javier Escaned: 3 Low contrast complex and CTO PCI
Giuseppe Tarantini: Protect IV and PROTECT-Europe trial
Giuseppe Tarantini: Protect IV and PROTECT-Europe trial
Masahisa Yamane: The Complex CTO Japanese Registry
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Kambis Mashayekhi: Trends and spin-offs from the EuroCTO Registry
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12:10 CASE 10 - Meyer-Gessner
- 1. Long complex RCA CTO Antegrade and retrograde surprise Markus Meyer-Geßner Augusta Krankenhaus Düsseldorf
- 2. 1. Antegrade first 2. Retrograde first 3. Dissection/Reentry first 4. Only PCI of peripheral anastomosis Your initial approach?
- 3. 1. Retrograde first – bifurcation at distal cap problems: angulation, unstable lesion ?, max. 20 min 2. Antegrade second - problems: nontapered stump, long lesion length, 3 bifurcations 3. Diss./Reentry third – problems: bifurcations, landing zone 4. PCI anastomosis only or after losing PDA fourth My initial approach
- 4. 1. Continue retrograde by dedicated microcatheters (Venture, Crusade…) 2. Antegrade 3. Dissection/Reentry 4. Only PCI of peripheral anastomosis Failure of retrograde wiring. Your next step?
- 5. 1. Retrograde by dedicated microcatheters (Venture, Crusade…) 2. Continue antegrade (different guide…IVUS…) 3. Dissection/Reentry 4. Only PCI of peripheral anastomosis Failure of antegrade wiring. Your next step?
- 6. 1. Retrograde by dedicated microcatheters (Venture, Crusade…) 2. Continue antegrade (…IVUS…) 3. Dissection/Reentry 4. PCI of peripheral anastomosis Ischemia/threatening closure of anastomosis. Your next step?
- 7. 1. Retrograde by dedicated microcatheters (Venture, Crusade…) 2. Continue antegrade (…IVUS…) 3. Complete Dissection/Reentry Anastomosis repaired, antegrade dissection/flow. Your next step?
- 8. Key learning points AL guide: sometimes friend, sometimes enemy Arterial grafts: sometimes as fragile as the venous conduits Experience with new microcatheter technology
- 9. Key learning points “You never walk alone” with Euro CTO Club 25 years experience in PCI, 5 years of inspiration