CTO meeting, CHR Citadelle Liège, 20/10/2017
Updated: Jan 11, 2018
Letter from the BWG-CTO
Dear friends and colleagues,
On Friday 20/10, at the CHR de la Citadelle Liège, the workshop on "Practical CTO recanalisation", organized by Dr. Yoann Bataille, Suzanne Pourbaix and Etienne Hoffer took place. The additional faculty consisted of Dr. Peter Kayaert, Johan Bennett, Claudiu Ungureanu, George Saad and myself.
The main focus was on life-cases. There were additional lectures on CTO-PCI, where do we stand now, on antegrade wire escalation, antegrade dissection and re-entry as well as on retrograde CTO interventions. The life-cases were performed in 2 separate cath lab rooms. Procedures had a different level of complexity, starting with an in-stent occlusion of the proximal LAD (J-CTO 1) where AWE was performed. The second patient had a complex RAC occlusion (J-CTO 3). In this patient the retrograde approach was demonstrated with a Guide-extension facilitated reverse-CART to externalize the wire.
The third patient was a post-ostial LAD occlusion (sharp take-off, blunt cap, long lesion with some calcification, J-CTO 4), in which a successful ADR was shown.
The fourth procedure was an excellent demonstration of an IVUS-guided blunt cap puncture (J-CTO 2).
The final patient had an unclear vessel path, at first glance good septal collaterals, which pushed towards a retro approach. Unfortunately, collaterals could not be crossed and a switch to an knuckle based ADR with blind re-entry was performed.
We, as a CTO community, can be proud that within the last couple of years, Belgian operators reached the capability to attack the final frontier in PCI, are able
to show these techniques without the support from "experts from abroad" and can share their experiences with colleagues and friends. All together, we did build up an important netw
ork, which needs to be sustained and reinforced.
Therefore, in the next future, we will strive to organize 2 Belgian CTO meetings per year, each time at different hospitals, where operators and attendees can exchange their knowledge, tips and tricks.
A big "thank you" and congratulations for the organizers as well for the com
pany Terumo, which supported the meeting. Close collaboration with companies will remain key to further develop our program, meetings and registry.