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2nd Edition ML CTO 2017

The 2nd Edition of the international Multi-level CTO Course was held in Nice (France) from June 29th 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
Operators: William Nicholson, MD & Khalid Tammam, MD
IVUS commentator: Stéphane Carlier, MD

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
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

  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

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

17:30 How would you approach that CTO? An interactive session
Presenters : Sébastien Levesque and Masahisa Yamane
18:15 Closing remarks
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
LIVE CASE #4: Dominant LCx CTO with ipsilateral collateral channels
Operators: Kambis Mashayekhi, MD & Alexander Bufe, MD
IVUS commentator: Stéphane Carlier, MD
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
11:30 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
  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
  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
17:30 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 Toolbox for effective dissection re-entry techniques
Jonathan Hill
18:45 The new Jedi meets Yoda: Q&A session
All Faculty members
19:00 Closing remarks
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
08:45 LIVE CASE #7: Blunt mid RCA CTO (Biotronik)
Operators: Georges Sianos, MD & Jonathan Hill, MD
IVUS commentator: Stéphane Carlier, MD
  PARALLEL SESSION: Case-in-box presentations
Late acquired malapposition and sub-occlusive restenosis after reverse CART for ostially occluded LAD - Erion Xhepa
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
12:15 LIVE CASE #8: RCA CTO with good landing zone (Boston, Guerbet)
Operators: Christopher Buller, MD & James Spratt, MD
IVUS commentator: Stéphane Carlier, MD
  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
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
17:40 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


Linked playlists

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ML CTO courses

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About Stéphane Rinfret

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8 Videos / Public / (Shared) /

ML CTO 2017: Live Cases Through this playlist you could watch the live cases that have been performed during the 2nd Edition of the Multi-Level CTO Course as well as the angiograms, t...


ML CTO 2017: Digital Extra of the Day

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MLCTO 2017 : Digital Extra of the Day The 2nd Edition of the international ML CTO congress was held in Nice (France) from June 29th to July 1st, 2017 at Palai...


ML CTO 2017 : Speakers' interviews

32 Videos / Public / (Shared) /

  Thursday, June 29th, 2017   Session 1: CTO PCI BASICS  Christopher Buller, MD: "Why should we treat CTOs: impact on ischemia and...


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