Friday 1500 meyer-gessner - rca ostial cto pci
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This document discusses the challenges of percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) of the right coronary artery (RCA) ostium. It notes that RCA ostial CTO PCIs have higher anatomical complexity, longer procedure times, higher radiation exposure, and lower success rates compared to non-ostial CTO PCIs. Retrograde wiring is often needed due to unclear anatomy, and reverse controlled antegrade and retrograde tracking (CART), snaring, or wire trapping techniques may be required when microcatheters cannot cross collaterals antegrade. Rotablation can help with severe calcification. The conclusions emphasize that additional imaging is generally needed due to unclear anatomy,
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Rna Folding
RNA folding is affected by transcription elongation. As the RNA is synthesized within the elongation complex, its ability to fold is constrained. This can affect downstream processes like intrinsic transcription termination that depend on the formation of RNA hairpin structures. Experiments using RNase T1 to probe RNA structures in elongation complexes at different positions show that the hairpin involved in intrinsic termination begins to form early but may not fully fold until after the RNA is released from the elongation complex. Competing RNA-RNA interactions or kinetic constraints of hairpin folding within the elongation complex can influence the efficiency of intrinsic termination.
08:15 Lombardi - Learning Antegrade Dissection and Re-entry
1. The document discusses techniques for learning antegrade dissection and re-entry (ADR) for chronic total occlusion percutaneous coronary intervention (CTO PCI), including using new devices like the Stingray balloon.
2. It presents an algorithm for provisional and hybrid approaches to CTO PCI incorporating techniques like antegrade and retrograde wiring, dissection, and re-entry.
3. The key to success is acquiring a variety of hybrid skills through teachable and reproducible methods in order to have multiple strategies for challenging cases.
09:50 Reifart - CTO tool kit
This document discusses strategies and tools for optimizing CTO procedures. It recommends:
1. Using long sheaths like Arrow to improve maneuverability and reduce friction.
2. Choosing a guiding catheter that provides stable support while allowing various devices through it, such as a 7F EBU or Amplatz.
3. Utilizing lubricious microcatheters like Corsair and guidewires like Confianza 9 to navigate tortuosity and calcification. Parallel wires and anchoring balloons can also help cross tough lesions.
Daniel Weilenmann - Guidewiresand microcatheters: how to use
The document discusses guidewires and microcatheters for chronic total occlusion procedures. It provides classifications of guidewires including conventional, support, and CTO wires. It describes specific guidewires such as Pilot 200 and Fielder XT and their uses for tasks like penetration, tortuosity, and knuckling. Microcatheters discussed include Corsair, Caravel, and Turnpike. The document presents a hybrid algorithm for CTO crossing incorporating both antegrade and retrograde approaches depending on lesion characteristics.
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The document promotes Decompression Massage Therapy (DMT) as a natural alternative therapy that is in high demand. It discusses how DMT uses negative pressure to stimulate tissue healing, reduce pain and edema, and enhance circulation. The document also outlines the business opportunities for therapists to incorporate DMT into their practice, such as attracting new clients, increasing income, and extending their careers. Equipment, training, marketing materials, and financing options are presented to help therapists adopt DMT.
IFR - Instantenous wave free ratio
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This document provides several tips and tricks for navigating tortuous coronary arteries during cardiac catheterization procedures:
1) Shorter and more flexible stents and balloons can be delivered through more tortuous segments. An "anchor" technique using a buddy balloon can also aid delivery.
2) Stiffer wires can cause spasm, so microcatheters, buddy balloons, and telescopic guide systems may help. The Hi-Torque Wiggle wire can deflect to pass tortuous segments.
3) While rapid-exchange devices are faster, over-the-wire devices may track and deliver better in tortuosity. Laser or rotablater should be avoided due to risk of complications
Choosing catheters & guidewires
The document discusses materials useful to have in stock for vascular surgery cases, including 3 types of guide wires, 4 diagnostic catheters, sheaths, balloons and stents, and peripheral stent grafts. It provides details on the types and uses of guide wires, catheters, sheaths, and other tools. Key catheters mentioned are Headhunter, Cobra, Motarjeme and Simmons. It recommends having 3 types of guide wires and answers questions about the most useful catheters and number of guide wire types needed.
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Rna Folding
RNA folding is affected by transcription elongation. As the RNA is synthesized within the elongation complex, its ability to fold is constrained. This can affect downstream processes like intrinsic transcription termination that depend on the formation of RNA hairpin structures. Experiments using RNase T1 to probe RNA structures in elongation complexes at different positions show that the hairpin involved in intrinsic termination begins to form early but may not fully fold until after the RNA is released from the elongation complex. Competing RNA-RNA interactions or kinetic constraints of hairpin folding within the elongation complex can influence the efficiency of intrinsic termination.
08:15 Lombardi - Learning Antegrade Dissection and Re-entry
1. The document discusses techniques for learning antegrade dissection and re-entry (ADR) for chronic total occlusion percutaneous coronary intervention (CTO PCI), including using new devices like the Stingray balloon.
2. It presents an algorithm for provisional and hybrid approaches to CTO PCI incorporating techniques like antegrade and retrograde wiring, dissection, and re-entry.
3. The key to success is acquiring a variety of hybrid skills through teachable and reproducible methods in order to have multiple strategies for challenging cases.
09:50 Reifart - CTO tool kit
This document discusses strategies and tools for optimizing CTO procedures. It recommends:
1. Using long sheaths like Arrow to improve maneuverability and reduce friction.
2. Choosing a guiding catheter that provides stable support while allowing various devices through it, such as a 7F EBU or Amplatz.
3. Utilizing lubricious microcatheters like Corsair and guidewires like Confianza 9 to navigate tortuosity and calcification. Parallel wires and anchoring balloons can also help cross tough lesions.
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The document discusses guidewires and microcatheters for chronic total occlusion procedures. It provides classifications of guidewires including conventional, support, and CTO wires. It describes specific guidewires such as Pilot 200 and Fielder XT and their uses for tasks like penetration, tortuosity, and knuckling. Microcatheters discussed include Corsair, Caravel, and Turnpike. The document presents a hybrid algorithm for CTO crossing incorporating both antegrade and retrograde approaches depending on lesion characteristics.
Dmt Review
The document promotes Decompression Massage Therapy (DMT) as a natural alternative therapy that is in high demand. It discusses how DMT uses negative pressure to stimulate tissue healing, reduce pain and edema, and enhance circulation. The document also outlines the business opportunities for therapists to incorporate DMT into their practice, such as attracting new clients, increasing income, and extending their careers. Equipment, training, marketing materials, and financing options are presented to help therapists adopt DMT.
IFR - Instantenous wave free ratio
A novel parameter to quantify the hemodynamic severity of coronary artery stenosis without adenosine infusion.
Tortuous vessel pci navin
This document provides several tips and tricks for navigating tortuous coronary arteries during cardiac catheterization procedures:
1) Shorter and more flexible stents and balloons can be delivered through more tortuous segments. An "anchor" technique using a buddy balloon can also aid delivery.
2) Stiffer wires can cause spasm, so microcatheters, buddy balloons, and telescopic guide systems may help. The Hi-Torque Wiggle wire can deflect to pass tortuous segments.
3) While rapid-exchange devices are faster, over-the-wire devices may track and deliver better in tortuosity. Laser or rotablater should be avoided due to risk of complications
Choosing catheters & guidewires
The document discusses materials useful to have in stock for vascular surgery cases, including 3 types of guide wires, 4 diagnostic catheters, sheaths, balloons and stents, and peripheral stent grafts. It provides details on the types and uses of guide wires, catheters, sheaths, and other tools. Key catheters mentioned are Headhunter, Cobra, Motarjeme and Simmons. It recommends having 3 types of guide wires and answers questions about the most useful catheters and number of guide wire types needed.
Guiding catheter in coronary intervention
1. Guide catheters provide support for advancing devices into coronary arteries and injecting contrast for visualization. Their selection depends on factors like coronary anatomy, aortic root size, and desired level of support.
2. Common guide catheters include the Judkins, Amplatz, and extra-backup guides. The Judkins provides balanced support while the Amplatz offers firm passive support. Long tip catheters provide coaxial support and manipulation.
3. Achieving proper coaxial alignment and maintaining backup support are important for device delivery and preventing complications. Catheter size, curves, and deep seating techniques impact the level of passive versus active support provided.
interventional cardiology, Guiding catheters, wires, and balloons equipment...
This document provides an overview of guiding catheters, guide wires, and balloons which are core equipment used in percutaneous coronary interventions (PCI). It describes the design characteristics, advantages, and disadvantages of over-the-wire and rapid exchange balloon catheters. Key attributes of balloons like entry, tracking, and compliance are defined. Guiding catheters are discussed in terms of size, shape, and selection for accessing different coronary arteries. Finally, guide wire features such as core material, coating, and tip design are reviewed alongside common wire types used in various clinical scenarios.
Drs Katoh, Suzuki, Tamai - 1995/96 in Frankfurt learning from each other push...
This document discusses the history and activities of the EuroCTO Club, a group dedicated to increasing success rates for chronic total occlusion percutaneous coronary intervention (CTO PCI). Key points:
- The Club was founded in 2006 in Frankfurt by interventional cardiologists wanting to exchange experience and develop common CTO PCI strategies.
- Early meetings involved analyzing cases to learn from each other. Success rates increased from their first attempt, where 9 of 10 CTO cases were successful.
- Over time the Club grew substantially, publishing papers and holding courses. Their online registry monitored over 4,300 cases to ensure data credibility.
- Monitoring of a sample of registry entries found high consistency, confirming the registry is a
Andrea Gagnor - Femoral is (still) better
This document discusses the use of radial versus femoral access for complex CTO PCI procedures. It notes that while radial access is associated with less radiation exposure and procedure time, it has technical limitations for complex CTO cases where larger devices are needed. The conclusion is that radial access can be used for simpler antegrade or retrograde CTO cases not requiring multiple devices, but femoral is generally better suited for more complex multi-device cases due to the ability to accommodate larger profiles. Safety must also be considered, as radial procedures are associated with risks like spasm that can prolong time.
08:25 Di Mario - Recent Pubblications and Research
- Recent publications on CTOs from 2013-2014 focused on pathology, physiology, epidemiology, outcomes, imaging, technical approaches, and stents.
- Studies showed differences in plaque characteristics between long and short duration CTOs and impact of revascularizing CTOs on donor arteries.
- Registry data from Sweden found a 10.6% prevalence of CTOs and decreasing rates over time.
- Successful CTO PCI was associated with improved survival, less cardiac death, and reduced need for CABG compared to failed procedures.
- Imaging like IVUS and CT angiography improved technical success rates for CTO PCI.
TomaszJ. Guzik - Is chronic total occlusion a step in atherosclerosis natural...
Chronic total occlusion may be more than just the natural progression of atherosclerosis. It may be a consequence of chronic plaque instability and inflammation over time. The pathogenesis of CTOs involves neovascularization within plaques, changes in plaque composition like necrosis, thrombosis, and calcification, and an increased inflammation score compared to other plaques. Understanding the biomarkers and pathogenesis of CTOs could help with prevention and treatment strategies for coronary artery disease.
Nicolaus Reifart - How to minimize radiation
This document provides 10 steps to minimize radiation exposure during percutaneous coronary interventions (PCI). It emphasizes applying the ALARA (as low as reasonably achievable) principle. The most important step is ensuring the procedure is truly necessary. Other key steps include using protective shielding close to the patient's body, positioning the detector closer to minimize scatter radiation, avoiding oblique angles when possible, reducing frame rates, using fluoroscopy instead of cine when able, and stepping back from the patient during imaging. Adopting these good radiation safety habits can reduce radiation dose by 30-80% depending on the technique. The document stresses tailoring dye usage based on kidney function and using superselective injections when possible to minimize dye consumption as well
Imre UNGI - Long-term out come of DES in CTOs
1) The document discusses long-term outcomes of drug-eluting stents (DES) compared to bare-metal stents (BMS) for treating chronic total occlusions (CTO).
2) Studies show that second-generation DES have better long-term outcomes than first-generation DES or BMS for CTO lesions.
3) Optical coherence tomography (OCT) findings indicate higher rates of uncovered and malapposed stent struts with DES in CTO lesions, suggesting increased risk of stent thrombosis, and importance of regular follow-up.
15:20 Tsuchikane - Retrograde complication
This document discusses complications that can occur during retrograde percutaneous coronary intervention (PCI) to treat chronic total occlusions (CTOs). It notes that retrograde approach relevant complications include channel perforation by wiring in epicardial arteries, channel rupture due to catheters in septal or epicardial arteries, and donor artery issues like thrombosis or dissection. Specific cases are presented where these complications occurred along with how they were addressed, such as prolonged balloon inflation, coil embolization, or neutralization of heparin. Prevention strategies are also discussed such as maintaining adequate activated clotting time and flushing guide catheters. The document aims to help operators dealing with CTO PCI to recognize and manage potential complications
Dimitri Karmpaliotis - CTO PCI in Post-CABG Patients
1) Over 100,000 CABG operations are performed annually in the US, with 10,000 re-do CABG procedures each year. Hundreds of thousands of post-CABG patients have occluded/degenerated grafts causing symptoms that are often under-treated.
2) CTO PCI in post-CABG patients is more technically challenging due to diffuse disease, calcified vessels, distortion of anatomy from vessel tenting, and progression of native vessel disease.
3) Technical success rates for CTO PCI in post-CABG patients have improved in recent years to over 80% due to improved techniques like retrograde recanalization, but it remains a difficult subset of patients with
Friday 0905 – christiansen – feasibility of a cto pci
This document provides guidance on evaluating the feasibility of percutaneous coronary intervention (PCI) for a chronic total occlusion (CTO). Key factors to consider include: the patient's tolerance for a long procedure, contrast load, and radiation exposure; the CTO's proximal cap ambiguity, length, distal landing zone, and presence of interventional collaterals; and ensuring good quality angiography. With adequate planning and use of appropriate CTO techniques, feasibility is nearly always present for symptomatic patients. Success rates of CTO-PCI are reported to be 94% when using a planned approach.
Heinz Joachim Buttner - RCA Recanalization in a post CABG patient
4th European Live Summit on Retrograde CTO Revascularization - May 8–9, 2015, in Zurich, Switzerland
Friday 1758 – goicolea pathology of cto
This document discusses the pathology of chronic total occlusions (CTOs) in coronary arteries. It summarizes findings from a study of 95 CTO lesions examining differences between CTOs with prior bypass grafting, long-duration CTOs without grafting, and short-duration CTOs without grafting. Key findings include that CTOs with prior grafting had more calcification and organized thrombus compared to long-duration CTOs, and short-duration CTOs had more necrotic cores. About half of proximal CTO lumens were abrupt while most distal lumens were tapered. CTOs with prior grafting and long-duration CTOs showed more negative arterial remodeling compared to short
17:55 - Wrapup
PCI for chronic total occlusions (CTO) has a low success rate for most operators, around 70%, while expert CTO operators have a success rate of 85-95%. Expert clubs have played an important role in standardizing techniques and consolidating knowledge, helping to increase the overall CTO success rate to around 80-90% of patients. The higher success rates of experts influences more widespread adoption of treating CTO patients.
Friday 1815 maccia assessing both patient and staff dose at once
This document discusses establishing a registry to monitor radiation doses for patients and staff during complex coronary angiography procedures called chronic total occlusions (CTO). It proposes a three-phase plan: 1) collecting technical and dose data from selected centers to establish baseline protocols, 2) expanding prospective data collection, and 3) promoting dissemination of results. The goal is to optimize radiation protection by providing protocols allowing the lowest possible doses for effective CTO procedures.
A. Bufe - LIVE in thebox CTO
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08:45 CASE 7 - Galassi - 01. A Likely “Simple” Reverse CART
This document summarizes a complex percutaneous coronary intervention to treat a chronic total occlusion of the right coronary artery using a reverse controlled antegrade and retrograde subintimal tracking (CART) technique. After several failed attempts using various guidewires and microcatheters, the interventionist was eventually able to establish subintimal access and wire crossing in both the antegrade and retrograde directions. An externalization maneuver was then performed and four drug-eluting stents were implanted, successfully revascularizing the target lesion. The interventionist notes that reverse CART can be an effective retrograde strategy and that antegrade intravascular ultrasound or alternative techniques like Crossboss may aid in complex cases.
Andrea Gagnor – Prevent complications
4th European Live Summit on Retrograde CTO Revascularization - May 8–9, 2015, in Zurich, Switzerland
10:00 Büttner - CTO PCI after CABG
CTO PCI in secondary revascularisation after CABG can be challenging due to worse lesion characteristics like heavy calcium. Bypass grafts, whether patent or occluded, can be used as conduits for retrograde guidewires using techniques like CART. Achieving complete revascularization after PCI late post-CABG is associated with better long-term outcomes and mortality compared to incomplete revascularization of one or more regions.
1105 Lefevre - How to perform
This document discusses how to perform and interpret coronary angiography for chronic total occlusion (CTO) recanalization. It emphasizes getting specific anatomic information from the angiogram such as vessel course, lesion length and characteristics, proximal and distal ambiguities, collateral circulation, and distal runoff to guide CTO PCI strategy and determine if a case is suitable. Key factors include obtaining high quality injection with optimal views of the occluded segment and ensuring good support is possible from donor vessels or collaterals. The angiogram should be studied in detail to answer questions about the CTO anatomy prior to attempting recanalization.
07 aimradial2016 fri2 P Montorsi
07 aimradial2016 fri2 P MontorsiInternational Chair on Interventional Cardiology and Transradial Approach
Transradial access for carotid artery stenting with proximal protection devices can be technically challenging but is safe and effective according to the presenter's experience. Of 382 carotid stenting procedures performed between 2012-2014, 267 used radial/brachial access and 76 used the Mo.Ma proximal protection system through radial/brachial access. The first attempt failure rate was 34.6% primarily due to sharp carotid artery bifurcation angles and device stiffness. Modified techniques including removing the Mo.Ma mandrel and using two guidewires improved the technical success rate to 98.6% with only 1.3% requiring conversion to a femoral approach. Periprocedural complications were low at 1.3% with no deathsKarl ISAAZ - CTO withHeavy Calcifications
This document discusses techniques for percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) with heavy calcification. It notes the difficulties posed by calcification, including inability to penetrate caps or advance wires and devices. Strategies discussed include long sheaths, large guiding catheters, stiff wires, guideliners, small balloons, microcatheters like Tornus and Turnpike, rotablator, laser, subintimal dissection with reentry, anchoring balloons, and wire escalation. Case examples demonstrate successful crossing with anchoring balloons, guideliner support, Turnpike catheter, and modified dissection and reentry. The conclusion stresses perseverance, augmented backup,
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Guiding catheter in coronary intervention
1. Guide catheters provide support for advancing devices into coronary arteries and injecting contrast for visualization. Their selection depends on factors like coronary anatomy, aortic root size, and desired level of support.
2. Common guide catheters include the Judkins, Amplatz, and extra-backup guides. The Judkins provides balanced support while the Amplatz offers firm passive support. Long tip catheters provide coaxial support and manipulation.
3. Achieving proper coaxial alignment and maintaining backup support are important for device delivery and preventing complications. Catheter size, curves, and deep seating techniques impact the level of passive versus active support provided.
interventional cardiology, Guiding catheters, wires, and balloons equipment...
This document provides an overview of guiding catheters, guide wires, and balloons which are core equipment used in percutaneous coronary interventions (PCI). It describes the design characteristics, advantages, and disadvantages of over-the-wire and rapid exchange balloon catheters. Key attributes of balloons like entry, tracking, and compliance are defined. Guiding catheters are discussed in terms of size, shape, and selection for accessing different coronary arteries. Finally, guide wire features such as core material, coating, and tip design are reviewed alongside common wire types used in various clinical scenarios.
Drs Katoh, Suzuki, Tamai - 1995/96 in Frankfurt learning from each other push...
This document discusses the history and activities of the EuroCTO Club, a group dedicated to increasing success rates for chronic total occlusion percutaneous coronary intervention (CTO PCI). Key points:
- The Club was founded in 2006 in Frankfurt by interventional cardiologists wanting to exchange experience and develop common CTO PCI strategies.
- Early meetings involved analyzing cases to learn from each other. Success rates increased from their first attempt, where 9 of 10 CTO cases were successful.
- Over time the Club grew substantially, publishing papers and holding courses. Their online registry monitored over 4,300 cases to ensure data credibility.
- Monitoring of a sample of registry entries found high consistency, confirming the registry is a
Andrea Gagnor - Femoral is (still) better
This document discusses the use of radial versus femoral access for complex CTO PCI procedures. It notes that while radial access is associated with less radiation exposure and procedure time, it has technical limitations for complex CTO cases where larger devices are needed. The conclusion is that radial access can be used for simpler antegrade or retrograde CTO cases not requiring multiple devices, but femoral is generally better suited for more complex multi-device cases due to the ability to accommodate larger profiles. Safety must also be considered, as radial procedures are associated with risks like spasm that can prolong time.
08:25 Di Mario - Recent Pubblications and Research
- Recent publications on CTOs from 2013-2014 focused on pathology, physiology, epidemiology, outcomes, imaging, technical approaches, and stents.
- Studies showed differences in plaque characteristics between long and short duration CTOs and impact of revascularizing CTOs on donor arteries.
- Registry data from Sweden found a 10.6% prevalence of CTOs and decreasing rates over time.
- Successful CTO PCI was associated with improved survival, less cardiac death, and reduced need for CABG compared to failed procedures.
- Imaging like IVUS and CT angiography improved technical success rates for CTO PCI.
TomaszJ. Guzik - Is chronic total occlusion a step in atherosclerosis natural...
Chronic total occlusion may be more than just the natural progression of atherosclerosis. It may be a consequence of chronic plaque instability and inflammation over time. The pathogenesis of CTOs involves neovascularization within plaques, changes in plaque composition like necrosis, thrombosis, and calcification, and an increased inflammation score compared to other plaques. Understanding the biomarkers and pathogenesis of CTOs could help with prevention and treatment strategies for coronary artery disease.
Nicolaus Reifart - How to minimize radiation
This document provides 10 steps to minimize radiation exposure during percutaneous coronary interventions (PCI). It emphasizes applying the ALARA (as low as reasonably achievable) principle. The most important step is ensuring the procedure is truly necessary. Other key steps include using protective shielding close to the patient's body, positioning the detector closer to minimize scatter radiation, avoiding oblique angles when possible, reducing frame rates, using fluoroscopy instead of cine when able, and stepping back from the patient during imaging. Adopting these good radiation safety habits can reduce radiation dose by 30-80% depending on the technique. The document stresses tailoring dye usage based on kidney function and using superselective injections when possible to minimize dye consumption as well
Imre UNGI - Long-term out come of DES in CTOs
1) The document discusses long-term outcomes of drug-eluting stents (DES) compared to bare-metal stents (BMS) for treating chronic total occlusions (CTO).
2) Studies show that second-generation DES have better long-term outcomes than first-generation DES or BMS for CTO lesions.
3) Optical coherence tomography (OCT) findings indicate higher rates of uncovered and malapposed stent struts with DES in CTO lesions, suggesting increased risk of stent thrombosis, and importance of regular follow-up.
15:20 Tsuchikane - Retrograde complication
This document discusses complications that can occur during retrograde percutaneous coronary intervention (PCI) to treat chronic total occlusions (CTOs). It notes that retrograde approach relevant complications include channel perforation by wiring in epicardial arteries, channel rupture due to catheters in septal or epicardial arteries, and donor artery issues like thrombosis or dissection. Specific cases are presented where these complications occurred along with how they were addressed, such as prolonged balloon inflation, coil embolization, or neutralization of heparin. Prevention strategies are also discussed such as maintaining adequate activated clotting time and flushing guide catheters. The document aims to help operators dealing with CTO PCI to recognize and manage potential complications
Dimitri Karmpaliotis - CTO PCI in Post-CABG Patients
1) Over 100,000 CABG operations are performed annually in the US, with 10,000 re-do CABG procedures each year. Hundreds of thousands of post-CABG patients have occluded/degenerated grafts causing symptoms that are often under-treated.
2) CTO PCI in post-CABG patients is more technically challenging due to diffuse disease, calcified vessels, distortion of anatomy from vessel tenting, and progression of native vessel disease.
3) Technical success rates for CTO PCI in post-CABG patients have improved in recent years to over 80% due to improved techniques like retrograde recanalization, but it remains a difficult subset of patients with
Friday 0905 – christiansen – feasibility of a cto pci
This document provides guidance on evaluating the feasibility of percutaneous coronary intervention (PCI) for a chronic total occlusion (CTO). Key factors to consider include: the patient's tolerance for a long procedure, contrast load, and radiation exposure; the CTO's proximal cap ambiguity, length, distal landing zone, and presence of interventional collaterals; and ensuring good quality angiography. With adequate planning and use of appropriate CTO techniques, feasibility is nearly always present for symptomatic patients. Success rates of CTO-PCI are reported to be 94% when using a planned approach.
Heinz Joachim Buttner - RCA Recanalization in a post CABG patient
4th European Live Summit on Retrograde CTO Revascularization - May 8–9, 2015, in Zurich, Switzerland
Friday 1758 – goicolea pathology of cto
This document discusses the pathology of chronic total occlusions (CTOs) in coronary arteries. It summarizes findings from a study of 95 CTO lesions examining differences between CTOs with prior bypass grafting, long-duration CTOs without grafting, and short-duration CTOs without grafting. Key findings include that CTOs with prior grafting had more calcification and organized thrombus compared to long-duration CTOs, and short-duration CTOs had more necrotic cores. About half of proximal CTO lumens were abrupt while most distal lumens were tapered. CTOs with prior grafting and long-duration CTOs showed more negative arterial remodeling compared to short
17:55 - Wrapup
PCI for chronic total occlusions (CTO) has a low success rate for most operators, around 70%, while expert CTO operators have a success rate of 85-95%. Expert clubs have played an important role in standardizing techniques and consolidating knowledge, helping to increase the overall CTO success rate to around 80-90% of patients. The higher success rates of experts influences more widespread adoption of treating CTO patients.
Friday 1815 maccia assessing both patient and staff dose at once
This document discusses establishing a registry to monitor radiation doses for patients and staff during complex coronary angiography procedures called chronic total occlusions (CTO). It proposes a three-phase plan: 1) collecting technical and dose data from selected centers to establish baseline protocols, 2) expanding prospective data collection, and 3) promoting dissemination of results. The goal is to optimize radiation protection by providing protocols allowing the lowest possible doses for effective CTO procedures.
A. Bufe - LIVE in thebox CTO
8th Experts Live CTO Workshop 2016, September, 30th - October 1st, 20116 in Krakow, Poland
08:45 CASE 7 - Galassi - 01. A Likely “Simple” Reverse CART
This document summarizes a complex percutaneous coronary intervention to treat a chronic total occlusion of the right coronary artery using a reverse controlled antegrade and retrograde subintimal tracking (CART) technique. After several failed attempts using various guidewires and microcatheters, the interventionist was eventually able to establish subintimal access and wire crossing in both the antegrade and retrograde directions. An externalization maneuver was then performed and four drug-eluting stents were implanted, successfully revascularizing the target lesion. The interventionist notes that reverse CART can be an effective retrograde strategy and that antegrade intravascular ultrasound or alternative techniques like Crossboss may aid in complex cases.
Andrea Gagnor – Prevent complications
4th European Live Summit on Retrograde CTO Revascularization - May 8–9, 2015, in Zurich, Switzerland
10:00 Büttner - CTO PCI after CABG
CTO PCI in secondary revascularisation after CABG can be challenging due to worse lesion characteristics like heavy calcium. Bypass grafts, whether patent or occluded, can be used as conduits for retrograde guidewires using techniques like CART. Achieving complete revascularization after PCI late post-CABG is associated with better long-term outcomes and mortality compared to incomplete revascularization of one or more regions.
1105 Lefevre - How to perform
This document discusses how to perform and interpret coronary angiography for chronic total occlusion (CTO) recanalization. It emphasizes getting specific anatomic information from the angiogram such as vessel course, lesion length and characteristics, proximal and distal ambiguities, collateral circulation, and distal runoff to guide CTO PCI strategy and determine if a case is suitable. Key factors include obtaining high quality injection with optimal views of the occluded segment and ensuring good support is possible from donor vessels or collaterals. The angiogram should be studied in detail to answer questions about the CTO anatomy prior to attempting recanalization.
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Drs Katoh, Suzuki, Tamai - 1995/96 in Frankfurt learning from each other push...
Drs Katoh, Suzuki, Tamai - 1995/96 in Frankfurt learning from each other push...
08:25 Di Mario - Recent Pubblications and Research
08:25 Di Mario - Recent Pubblications and Research
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TomaszJ. Guzik - Is chronic total occlusion a step in atherosclerosis natural...
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Dimitri Karmpaliotis - CTO PCI in Post-CABG Patients
Friday 0905 – christiansen – feasibility of a cto pci
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Friday 1815 maccia assessing both patient and staff dose at once
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07 aimradial2016 fri2 P Montorsi
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Transradial access for carotid artery stenting with proximal protection devices can be technically challenging but is safe and effective according to the presenter's experience. Of 382 carotid stenting procedures performed between 2012-2014, 267 used radial/brachial access and 76 used the Mo.Ma proximal protection system through radial/brachial access. The first attempt failure rate was 34.6% primarily due to sharp carotid artery bifurcation angles and device stiffness. Modified techniques including removing the Mo.Ma mandrel and using two guidewires improved the technical success rate to 98.6% with only 1.3% requiring conversion to a femoral approach. Periprocedural complications were low at 1.3% with no deathsKarl ISAAZ - CTO withHeavy Calcifications
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Jo Dens, Genk, Belgium
Room:
West Foyer - Friday 11:40
Chairmen:
Alexander Ghanem, Hamburg, Germany;
Luca Grancini, Milan, Italy; Florian Krötz, Starnberg, Germany
Meyer-Geßner - Session 1 - Antegrade euro cto algorithm
This document discusses techniques for treating chronic total occlusions (CTOs) using an antegrade approach. It presents the Euro CTO algorithm for selecting strategies based on a CTO's complexity. For easier CTOs with clear access, a single wire may suffice. More complex CTOs may require wire escalation or parallel wiring. Very complex CTOs may benefit from dissection/reentry techniques or a retrograde approach. The antegrade approach remains standard, but alternative techniques have a role when antegrade skills fail or a CTO is especially challenging. The Euro CTO algorithm aims to select the best strategy for each patient's unique CTO.
Markus Meyer Gessner - Break through the wall- RCA ostial CTO
4th European Live Summit on Retrograde CTO Revascularization - May 8–9, 2015, in Zurich, Switzerland
Abdul Mozid: New developments in wire based antegrade approach
14th Experts "Live" CTO
September 2nd- 3rd, 2022 - Mainz, Germany
Main Session - Session 2:
Selecting the patient and planning the procedure B
New developments in wire based antegrade approach
Abdul Mozid, Leeds, United Kingdom
Room:
Guteberg Hall (Auditorium) - Friday 13:20
Chairmen:
Alexander Bufe, Krefeld, Germany;
Leszek Bryniarski, Krakow, Poland;
Hans Bonnier, Nuenen, Belgium
Long CTO with tortuosity, calcifications: How to progress inside the CTO segment
This document summarizes a presentation on techniques for crossing chronic total occlusions (CTOs) with severe tortuosity and calcification. It discusses scoring systems used to assess CTO difficulty and provides examples of six complex CTO cases treated with techniques like knuckle wiring, anchoring balloons, retrograde wiring through collateral channels, the Carlino technique, and rotational atherectomy. The key takeaways are that tortuous and calcified CTOs require careful planning, mastery of techniques like knuckle wiring and the Carlino method, and a willingness to be creative and persistent when standard approaches fail.
Retrograde microcather cannot cross the lesion: tips & tricks
Retrograde microcather cannot pass the lesion
Roberto Garbo, Turin, Italy
10th Experts „Live“ CTO Workshop - Day2
Felix Woitek: Impulse: How to address CTO and Bifurcation
14th Experts Live CTO
September 2nd - 3rd, 2022 - Mainz, Germany
AGIK Parallel Session - Session 3:
The 101 of antegrade approach
Impulse: How to address CTO and Bifurcation
Mohamed Ayoub, Bad Oeynhausen, Germany
Room:
West Foyer - Friday 15:00
Chairmen:
Michael Behnes, Mannheim, Germany;
Felix Woitek, Dresden, Germany
Trends in Future CommunicationsInternational Workshop - Renato Rabelo
This document summarizes research on electro-optic tunable sparse gratings in lithium niobate waveguides for applications in dense wavelength division multiplexing (DWDM) communication systems. It describes the fabrication of titanium diffused lithium niobate waveguides with silicon dioxide strain gratings to achieve mode conversion between the transverse electric and transverse magnetic modes. Test results show over 96% polarization conversion efficiency across the C-band with a free spectral range of 9.131 GHz. The device operates by applying a voltage to integrated electrodes to tune the polarization response across a wide wavelength range.
CONTOH Flux test cctv utp test report
The document reports on the results of testing various Category 6 cables. It provides the results of 22 cable tests, listing the cable ID, test summary (all passed), test limits, length of the cable, and margin above the limit for the worst case measurement in each test. The cables that were tested ranged in length from 9 feet to 194 feet. All cables passed the tests for NEXT, ACR-F, ACR-N, and RL.
Parallel wire using dual-lumen catheters
Parallel wire using dual-lumen catheters
Gerald S. Werner, Darmstadt, Germany
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
International Montoro Resources Inc. (IMTFF- USA) (IMT -TSXV) (O4T1-Frankfurt...
International Montoro Resources Inc. (IMTFF- USA) (IMT -TSXV) (O4T1-Frankfurt...Follow me on Twitter @Stockshaman
Geotech Report: for International Montoro Resources Serpent River. Pecors Anomoly 2D ZTEM Inversion Results. With 3D modelling.Gerald Werner - AntegradeApproach Step by Step
This document discusses the antegrade approach for treating chronic total occlusions (CTOs). The goals are to restore the original artery anatomy with minimal damage or time/resources. The antegrade approach involves analyzing the lesion and patient, using a step-by-step process starting with softer wires and progressing if needed. Parallel wiring is an early bailout option. Guided reentry may be used if retrograde proves difficult. The strategy aims to select the approach most likely to succeed for each specific lesion and patient.
10:50 Ochiai - 10 key points to avoid major complications during CTO PCI
1. The 10 key points provide guidance on avoiding major complications during chronic total occlusion percutaneous coronary intervention (CTO PCI).
2. The points emphasize minimizing radiation exposure, using high quality angiograms to plan strategies, monitoring activated clotting time, ensuring all devices are visible on fluoroscopy, using large guiding catheters without stiff tips, identifying the entry point into the CTO, using intravascular ultrasound, employing spring coil wires for collateral tracking, using knuckle wiring when vessel course is unclear, and guaranteeing stent delivery into the left circumflex artery during ostial left anterior descending CTO procedures to avoid complications.
3. The document illustrates each point using images from CTO PCI cases.
Ad7716
The document describes the AD7716, a 22-bit data acquisition system. It has four analog input channels that use sigma-delta analog-to-digital converters with on-chip digital filtering. The device can process data from up to 32 channels in a simple system and has programmable filter cutoff frequencies from 584Hz to 36.5Hz. It is used in applications like biomedical data acquisition, process control, and seismology.
09 aimradial2016 fri2 C Trani
09 aimradial2016 fri2 C TraniInternational Chair on Interventional Cardiology and Transradial Approach
This document discusses the radial artery approach for lower extremity interventions. Some key advantages of the radial approach include simultaneous access to both limbs, feasibility even when the femoral or iliac arteries are involved, better patient acceptance, and reduced access site complications compared to the femoral approach. However, there are some technical limitations to consider with the radial approach due to the smaller size of the radial artery and greater distance to target lesions in the legs. New devices are being developed to help overcome these challenges and make transradial peripheral procedures more similar to coronary interventions.Kambis Mashayekhi: Keynote: My essential tipps & tricks for success in compli...
14th Experts Live CTO
September 2nd - 3rd, 2022 - Mainz, Germany
AGIK Parallel Session - Session 5:
Essential tools for complication management
Keynote: My essential tipps & tricks for success in complication management
Kambis Mashayekhi, Lahr, Germany
Room:
West Foyer - Saturday 12:30
Chairmen:
Dimitrios Karmpaliotis, Morristown, USA;
Kambis Mashayekhi, Lahr, Germany;
Andrea Gagnor, Turin, Italy
Lika Electronic Absolute Encoders with Profinet Interface
A brief description of Lika Electronic encoders with Profinet interface. Find more at http://www.lika.it/eng/prodotti.php?id_cat=267&id_fam=270&id_sfam=492
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Application of retrograde dual lumen microcatheter for a chronic total occlus...
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Meyer-Geßner - Session 1 - Antegrade euro cto algorithm
Meyer-Geßner - Session 1 - Antegrade euro cto algorithm
Markus Meyer Gessner - Break through the wall- RCA ostial CTO
Markus Meyer Gessner - Break through the wall- RCA ostial CTO
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Abdul Mozid: New developments in wire based antegrade approach
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Long CTO with tortuosity, calcifications: How to progress inside the CTO segment
Retrograde microcather cannot cross the lesion: tips & tricks
Retrograde microcather cannot cross the lesion: tips & tricks
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Trends in Future CommunicationsInternational Workshop - Renato Rabelo
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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
Masahisa Yamane: The Complex CTO Japanese Registry
Kambis Mashayekhi: Trends and spin-offs from the EuroCTO Registry
Kambis Mashayekhi: Trends and spin-offs from the EuroCTO Registry
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Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
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Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
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Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. biomechanics of running. Dr.dhwani.pptx
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
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Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
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- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
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Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
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Friday 1500 meyer-gessner - rca ostial cto pci
- 1. RCA ostial CTO PCI: Allways a challenge! Markus Meyer-Geßner Augusta-Krankenhaus Düsseldorf Altbier Altstadt/ Rheinpromenade
- 2. 2 Case 1 : Mr. BH, 55a , CTO RCA ostium, 2. attempt 3VD, previous PCI LAD and LCX, unsuccessfull CTO PCI RCA outside, referred for 2. attempt, ischemia/viability +/+
- 3. 3 Selective injection: long channel, no retrograde stump Corsair/ Sion black
- 4. 4 wires not coaxialUltimate 3 g retrograde, antegrade Gaia 1 unstable
- 5. 5 Retrograde Confianza Pro betterAntegrade IMA 7F SH better
- 6. 6 Retrograde Confianza Pro good!RAO
- 7. 7 Tip-In with antegrade Corsair But: wire and Corsair blocked -> wire out , distorted Trapping: Retrograde Corsair stucks Retrograde wire stucks
- 8. 8 Antegrade access created -> Reverse CART 2,0/20mm and Ultimate 3g
- 10. 10 2 DES 3,5/ 76mm procedure time 212 min, dye 160 ml, fluoro time 109,9 min, AK 1848 mGy Final result
- 11. 11 Case 2: Mr. MJ, 55a , CTO RCA ostium without stump AP CCS III, ischemia/viability documented
- 12. 12 „Exophytic ostial calcium block, CTO channel filled by calcium, length 35mm“ -> not encouraging! CT scan -> anatomy of ostium/CTO channel?
- 13. 13 No guide for antegrade work Retrograde via 1. septal
- 14. 14 Corsair stucks in septum Finecross-cross
- 15. 15 Selective injection: multisegmental occlusion, short ostial part, antegrade IMA 7F „nearby“ Ultimate 3 g crosses
- 16. 16 Finecross stucks at tip of guide
- 17. 17 Change to RG3 in aorta Snare in brachiocephalic trunc
- 18. 18 4 DES, 3,5/ 100 mm procedure time 209min, fluoro 86,4 min, AK 2474 mGy, dye 90ml Concertina effect at ostium After correction by additional stent
- 19. 19 Snaring with antegrade transradial access Quattro Pro Elite Snare 35 mm in brachiocephalic trunc Change to RG3
- 20. 20 Peripheral IVUS (thanks to Roberto Garbo) Rotablator Helpfull tools
- 21. 21 Data from Euro CTO Club registry 2012- 7.2015 N= 9408 (preliminary values) RCA-ostial other lesions n 378 (4 %) 9030 (96 %) age (mean) 64 63,6 women (%) 20 15 lesion length (mm) 43,4 30,7 J-CTO - score (mean) 3,2 2,3 antegrade only (%) 38 73 retrograde only (%) 37 11 antegrade and retrograde (%) 25 16 stent length (mm) 78,4 62,3 procedural time (min) 140,1 106,2 fluoro time (min) 62,5 41,2 DAP (cGY X qcm) 21326 17026 contrast (ml) 317,5 292,2 Success (n) 295 7808 Success Rate (%) 78 87
- 22. Conclusions ERCTO data confirms higher anatomical complexity, workload for the operator and burden for the patient with lower success rate in RCA ostial CTO PCI Retrograde approach more frequent Unclear anatomy -> additional imaging Differential use of microcatheter for collateral crossing Standard strategies: direct wire crossing , with antegrade access: reverse CART Snaring or Tip-In for problems with microcatheter crossing in antegrade guide Rotablator for severe calcification
- 23. Altbier Altstadt/ Rheinpromenade Thank You Euro CTO Club Meeting Istanbul 18.-19.09.2015 RCA ostial CTO PCI – allways a challenge Markus Meyer-Geßner Augusta-Krankenhaus Düsseldorf