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

1. D. N. male 64 yo

2. Proximal RCA CTO with collateral circulation from RCA branches and septal branches from LAD
RCA coronary angiography

4. First unsuccessful attempt of anterograde approach >
retrograde approach wiring septal collateral

5. REVERSE CART

6. REVERSE CART
Cap anterograde puncture with GAIA 4 Next Generation

7. FINAL RESULT
Selution 2x40mm 60sec

8. Xience Skypoint 2x28 implantation +
POBA with NC 3.0 and 3.5
FINAL RESULT

9. Medical History
- Male, 46 yo.
- CVRF: arterial hypertension, CAD familiar history (father suffered from MI at the age of 63), obesity (BMI
41), dyslipidemia, previous smoker, hyperhomocysteinemia
- April 2023 post-exertional jugular pain, lasted for many hours > 4 days after, emergency dept access.
- Therapy : Aspirin 100 mg; Ticagrelor 90 mg x 2; PPI 40 mg; Ranolazine 500 mg x2 Atorvastatin/Ezetimibe 80/10
mg 1 cpr; Valsartan 40 mg.

11. - Echocardiogram: preserved LVEF 54%, inferior basal wall hypokinesia, mild mitral regurgitation

12. RCA - CORONARY ANGIOGRAPHY

13. LCA - CORONARY ANGIOGRAPHY

14. RCA fills by means of collateral circulation from the left coronary artery

15. RCA – failure of attempt to disrupt proximal CTO

16. LAD PCI
Drug eluting stent implantation on mid LAD and POBA of D1

17. LAD PCI – final result

18. CCTA
Four months later, new cardiological evaluation for persistence of chest pain and exertional dyspnea

19. x
x
x
x
x
4

20. SETTING
- Bifemoral access (incoercible radial spasm) 6F
- AL2 6F GC for antegrade
- JL4 diagnostic catheter for retrograde

21. Antegrade attempt with GAIA 3

22. Changing to a Runthrough guidewire and evidence of subintimal position of the guidewire

23. Switching to retrograde (changing the setting with bifemoral 7F 45cm, JR4 7F for antegrade and
EBUY

29. PARTICIPANTS
394
FACULTY
101
SPONSOR &
EXHIBITORS
16