ML CTO 2017

2^nd Edition ML CTO 2017

The 2^nd Edition of the international Multi-level CTO Course was held in Nice (France) from June 29^th to July 1st, 2017 at Palais de la Méditerranée, and brought together over 450 participants from 40 countries. Following the success of the 2016 first Edition, the main goal of this event was to bring together all passionate operators in one place: from beginners to experts in a climate of openness and congeniality. This conference, with simultaneous translation in English and French, was organized on 3 days modules:

• Module 1 - Module dedicated to operators willing to learn and/or reinforce their CTO knowledge on: antegrade basic techniques and strategies - first steps in retrograde.
• Module 2 - Module dedicated to regular operators willing to master more advanced techniques: complex antegrade - first steps in antegrade dissection re-entry.
• Module 3 - Module dedicated to experienced operators mastering all CTO techniques and strategies: complex retrograde - complex ADR - complications. Module based on interactivity and exchanges about personal and practical experiences.

Each module included live cases performed by national and international experienced operators, with associated didactic lectures and interactive discussions, related to the topics covered during sessions.

For more information about the Scientific Program and the Faculty Guests, we invite you to navigate through the ML CTO website.

THURSDAY JUNE 29th (Level 1: Discover CTO PCI)

Session 1: CTO PCI basics

Provoker: Alexandre Avran
Chairman: James Spratt
Panelists: Emmanouil Brilakis, Nicolaus Reifart & Mike Wyman
 

08:00	Introduction Alexandre Avran and Stéphane Rinfret
08:10	Why should we treat CTOs: impact on ischemia and LV function Christopher Buller
08:20	Recent trials on CTO PCI: should it change practice? Stéphane Rinfret
08:30	Coronary angiography in planning for CTO PCI Laurent Quilliet
08:40	CTO angiographic analysis: scoring systems and algorithms Marouane Boukhris
08:50	Requirements for initiation of CTO PCI program: Tools and set up Thomas Hovasse

Live case #1

Long proximal LCx CTO with ipsilateral and controlateral visualization
ACROSTAK - MEDTRONIC
Operators: William Nicholson, MD & Khalid Tammam, MD
IVUS commentator: Stéphane Carlier, MD
 

09:00	Live case Clinical presentation
09:10	Starting procedure

Parallel session: Case-in-box presentations
Wake up or close: tips & tricks for complications – Risto Jussila
 

10:10	Vascular access and guide selection for CTO PCI Khaldoon Alaswad
10:20	Essential basic maneuvers for CTO PCI Colm Hanratty
10:30	How to prevent common complications? Javier Escaned
10:40	Radioprotection and contrast management Nicolaus Reifart

Session 2: Antegrade CTO PCI basics

Provoker: Christopher Buller
Chairman: Colm Hanratty
Panelists: Khaldoon Alaswad, Jo Dens & Javier Escaned
 

11:15	Antegrade strategy with sequential wire escalation James Spratt
11:30	Modern parallel wire technique Daniel Weilenmann

Live case #2

Dominant LCx CTO with septal collateral channels
ASAHI-BIOSENSORS
Operators: Satoru Sumitsuji, MD & Nicolas Boudou, MD
IVUS commentator: Stéphane Carlier, MD
 

11:45	Live case Clinical presentation
12:00	Starting procedure

Parallel session: Case-in-box presentations
Dangerous curves - Lorenzo Azzalini
 

13:00	How and when to use dual-lumen catheters Nicolas Lhoest
13:10	How to improve guide catheter support Benjamin Faurie

Session 3: Retrograde CTO PCI basics

Provoker: Alaswad Khaldoon
Chairman: Benjamin Faurie
Panelists: Alexander Bufe, Artis Kalnins & Khalid Tammam
 

14:30

Retrograde approach: step-by-step instructions William Nicholson

Live case #3

Long mid RCA CTO with a good landing zone
HEXACATH – VASCULAR SOLUTIONS/TELEFLEX
Operators: Emmanouil Brilakis, MD & Mike Wyman, MD
IVUS commentator: Stéphane Carlier, MD
 

14:45	Live case Clinical presentation
15:00	Starting procedure

Parallel session: Case-in-box presentations
Ipsilateral epicardial retrograde CTO PCI over single radial access - Gregor Leibundgut
 

16:00	Reverse-CART technique Masahisa Yamane
16:15	Dissection technique using knuckled wires: use and indication Elliot Smith
16:25	Externalization and snaring techniques Satoru Sumitsuji

Provoker: Benjamin Faurie
Chairman: Stéphane Rinfret
Panelists: Sébastien Levesque, Sudhir Rathore & Masahisa Yamane
 

17:10	Industry session
17:30	How would you approach that CTO? An interactive session Presenters : Sébastien Levesque and Masahisa Yamane
17:50	Debate: Tip injection should always be used to guide septal collateral crossing? Pro : Sudhir Rathore Con : Stéphane Rinfret
18:05	MLCTO career achievement interview with Dr Heinz Joachim Büttner
18:15	Closing remarks

Exclusive on Incathlab.com: Digital Extra of the Day 
Lecture of Dr Antonio Serra: BVS implantation in chronically occluded vessels

 

FRIDAY JUNE 30th (Level 2: Progress in CTO PCI)

Session 1: Advanced Antegrade Techniques

Provoker: Christopher Buller
Chairman: Elliot smith
Panelists: Marouane Boukhris, Omer Goktekin & Daniel Weilenmann
 

08:30	Microcatheter overview: how to choose and use Paul Knaapen
08:45	When you cannot cross the proximal cap with a microcatheter Jonathan Hill

Live case #4

Dominant LCx CTO with ipsilateral collateral channels
ABBOTT
Operators: Kambis Mashayekhi, MD & Alexander Bufe, MD

IVUS commentator: Stéphane Carlier, MD
 

09:00	Live case Clinical presentation
09:10	Starting procedure

Parallel session: Case-in-box presentations
Tips & Tricks -Thierry Lefèvre
 

Session 2: Advanced procedural guidance and complications management

Provoker: Stéphane Rinfret
Chairman: Christopher Buller
Panelists: Heinz Joachim Büttner, Nicolas Lhoest & Khalid Tammam
 

11:00	IVUS during CTO PCI Roberto Garbo
11:15	Principles of contrast modulation techniques Mauro Carlino

Live case #5

Ostial LAD CTO with short left main and ipsilateral and contralateral collateral channels
TERUMO
Operators: Masahisa Yamane, MD & Alexandre Avran, MD
IVUS commentator: Stéphane Carlier, MD
 

11:30	Live case Clinical presentation
11:40	Starting procedure

Parallel session: Case-in-box presentations
RCA ostial CTO and snaring – Andrea Gagnor
 

13:00	How to manage ambiguous proximal cap without a retrograde option   Alexander Bufe
13:15	How to manage CTO PCI complications Emmanouil Brilakis
13:30	Perforations: the complete toolbox and how to use it Kambis Mashayekhi

Session 3: Basics in Antegrade Dissection Re-entry

Provoker: Kambis Mashayekhi
Chairman: Max Amor
Panelists: Yangsoo Jang, Sanjog Kalra & Nicolaus Reifart
 

14:45

Toolbox for effective dissection re-entry techniques Jonathan Hill

Live case #6

LCx CTO with ambiguous proximal cap
ALVIMEDICA – VOLCANO/PHILIPS
Operators: Roberto Garbo, MD & Andrea Gagnor, MD
IVUS commentator: Stéphane Carlier, MD
 

15:00	Live case Clinical presentation
15:10	Starting procedure

Parallel session : Case-in-box presentations
Heavily calcified distal RCA CTO uncrossable with device neither retrogradely nor anterogradely - Meruzhan Saghatelyan


Provoker: Thierry Lefèvre
Chairman: Alexander Bufe
Panelists: Georges Sianos,  Mauro Carlino & Paul Knaapen
 

17:00	Industry-supported session
17:15	Device-based ADR: step-by-step instructions Mike Wyman
17:30	Wire-based ADR: bailout indications and Mini-Star technique Alfredo Galassi
17:45	How would you approach that CTO? An interactive session Presenters: Lorenzo Azzalini and Mauro Carlino

Session 4: CTO PCI for Fellows

Chairman: Alexandre Avran
Panelists: Nicolas Boudou, Emmanouil Brilakis & Stéphane Rinfret
 

18:00	The hybrid algorithm: choosing the right approach Emmanouil Brilakis
18:15	Case presentations
18:45	The new Jedi meets Yoda: Q&A session All Faculty members
19:00	Closing remarks

   Exclusive on Incathlab.com: Digital Extra of the Day
Lecture of Dr Daniel Weilenmann: Management of septal complications   

SATURDAY JULY 1st (Level 3: Master CTO PCI)

Session 1: Retrograde advanced strategies

Provoker: Elliot Smith
Chairman: Alfredo Galassi
Panelists: Philippe Durand, Andrea Gagnor & William Nicholson
 

08:30

Solution for difficult retrograde re-entry Yangsoo Jang

Live case #7

Blunt mid RCA CTO
BIOTRONIK
Operators: Georges Sianos, MD & Jonathan Hill, MD
IVUS commentator: Stéphane Carlier, MD
 

08:45	Live case Clinical presentation
09:00	Starting procedure

Parallel session: Case-in-box presentations
Late acquired malapposition and sub-occlusive restenosis after reverse CART for ostially occluded LAD - Erion Xhepa
 

10:15	Wire crosses septal channel but microcatheter doesn’t follow: what to do? Gerald Werner
10:30	Retrograde approach through epicardial collateral channels Kambis Mashayekhi
10:45	Ping-pong technique for retrograde approach Nicolas Boudou

Session 2: Antegrade Dissection Re-entry Advanced Strategies

Provoker: Alexandre Avran
Chairman: Jonathan Hill
Panelists: Kambis Mashayekhi, Satoru Sumitsuji & Mike Wyman
 

11:25	How would you approach that CTO? An interactive session Presenters: Kambis Mashayekhi and Alexandre Avran
11:45	Difficult ADR situations: how to handle? Colm Hanratty
12:00	How to deal with ostial RCA CTOs Alexandre Avran

Live case #8

RCA CTO with good landing zone
BOSTON – GUERBET 
Operators: Christopher Buller, MD & James Spratt, MD
IVUS commentator: Stéphane Carlier, MD
 

12:15	Live case Clinical presentation
12:30	Starting procedure

Parallel session: Case-in-box presentations
Multivessel Disease with double CTO - Eugenio La Scala
 

Session 3: Difficult CTO PCI, Costs and outcomes

Provoker: Jonathan Hill
Chairman: Masahisa Yamane
Panelists: Max Amor, Laurent Drogoul & Risto Jussila
 

14:50	The RECHARGE registry: what have we learned? Jo Dens
15:00	Specific issues with post-CABG CTOs Heinz Joachim Büttner

Parallel session: Case-in-box presentations
Previous CABG alter the native coronary disease nature - Albert Alahmar, MD
 

16:25

Industry session

Chairman: Omer Goktekin
Panelists: Colm Hanratty, Thomas Hovasse & Daniel Weilenmann

17:15	Supported CTO PCI using percutaneous left ventricular assist devices Sanjog Kalra
17:30	Cost of CTO PCI: the cathlab manager perspective Aurélie Fresselinat
17:40	How are they doing? Angiographic follow-up of last year cases Laurent Drogoul
18:00	Take home messages and conclusion Alexandre Avran and Stéphane Rinfret

 

PARAMEDICS SESSION - THURSDAY JUNE 29th

This session will be in French, without English translation

Modérateurs : Dr Nicolas Lhoest & Hervé Faltot

08:30	Ouverture de la journée
08:40	Pourquoi et comment démarrer un programme CTO ? Hervé Faltot
08:50	Présentation clinique du live case
09:00	Live case n°1

Session 1 : La désobstruction: Enjeux et Outils

Modérateurs : Dr Nicolas Lhoest & Hervé Faltot

10:00	Désobstruction des occlusions coronaires chroniques : Pourquoi ? Pour qui ? Fanny Villanova
10:15	Les outils incontournables Gilles Wilhelm
10:30	Techniques antérogrades de désobstruction Dr Nicolas Lhoest

Modérateurs : Dr Alexandre Avran & Hervé Faltot

11:30	Techniques rétrogrades de désobstruction Dr Alexandre Avran
11:45	Présentation clinique du live case
12:00	Live case n°2

Modérateurs : Dr Max Amor & Hervé Faltot

14:15	Présentation clinique du live case
14:30	Live case n°3 (inclus 30mn de préparation paramédicale)

Session 2 : Management et sécurité du patient

Modérateurs : Dr Max Amor & Hervé Faltot

15:45	Préparation en amont de la procédure Nathalie Lattarico
16:00	Assistance per CTO : le méthode McGill Nathalie Ferlatte
16:15	Surveillance per-procédure Rafik Lamari
16:30	Gestion post désobstruction Sabrina Benmesbah
16:45	Take Home Messages

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