The Experts “Live”

The Experts “Live”Workshop 2013September, 27 th -28 th , 2013Paris, FranceHotel Pullman Paris-Montparnassewww.eurocto2013.comFinal ProgramEndorsed by:European Association ofPercutaneous CardiovascularInterventions (EAPCI)

The Experts „Live“Workshop 2013Course DirectorsThierry LefèvreHospital Privé Jacques CartierMassy, FranceYves LouvardInstitut HospitalierJacques CartierMassy, FranceECC-PresidentGerald S. WernerMedizinische KlinikKlinikum DarmstadtDarmstadt, GermanyDear colleagues,Dear friends,As things stand today, angioplasty of chronic total occlusion remains an infrequentlyimplemented treatment strategy. Isolated chronic total occlusions aregenerally treated medically, whereas CTOs diagnosed in the setting of multiplevessel disease constitute a definite indication for surgical treatment. However, itis crucial to bear in mind that these stable lesions may be responsible for angina,dyspnea or silent myocardial ischemia, deterioration of left ventricular function andincreased risk of arrhythmia. Last but not least, they may also account for a significantlyhigher mortality rate in patients with STEMI.Several well-known pioneers have been working on the development of efficientCTO treatment techniques for a long time and their data show a reduction inmid-term mortality in patients with patent arteries compared with persistentocclusions. The European CTO club was founded in 2006 and is the sponsor of thelargest (1,200 patients) of the three ongoing randomized trials comparing PCI withmedical treatment in patients with CTO.This club of experts is currently preparing its 5th Experts’ Live Workshop, which willtake place in Paris in September 2013. This course has been designed for interventionalcardiologists who are seeking to include CTO angioplasty in their therapeuticarsenal or to broaden their activity in this setting. This educational session willprovide them with practical information on basic or complex CTO techniques andspecific devices manufactured by the industry in addition to recommendationsregarding cath-lab equipment and logistics. They will also be given recommendationson how to enhance the learning process, optimize radiological safety for bothpatients and operators and improve the management and prevention of potentialcomplications.As far as specialists are concerned, whether they belong to the CTO club or not,they will resume their debate on the best available strategic options by taking anactive part in ‘live in a box’, lectures and controversy sessions chaired by the mosteminent international experts.We look forward to sharing a congenial, fruitful and scientifically uplifting educationalsession with you.Welcome to Paris!Thierry Lefevre and Yves Louvard4 5

www.terumo-europe.comThe Experts „Live“Workshop 2013Scientific ProgramFriday, September, 27 th , 20138:00–10:20 Session 1Basic and NewsChairmen: Nicolaus Reifart, Germany; Omer Goktekin, Turkey;Osamuh Katoh, Japan08:00 WelcomeYves Louvard, Massy, France08:05 CTO definitions / ECC consensusGeorge Sianos, Thessaloniki, Greece08:25 What is a good CTO angiogram?Alexander Bufe, Wuppertal, GermanyAnzeige TERUMO08:40 What is new in literature since the last meeting?Imad Sheiban, Turin, ItalySimple antegrade casesDiscussants: Victoria Martin, Spain; Alexander Bufe, Germany;Simon Elhadad, France; Tevfik Gürmen, Turkey09:00 Case 1: A simple RCA CTO: basic techniquesYves Louvard, Massy, France09:25 Case 2: Intrastent CTO: IVUS guided antegrade approachGerald Werner, Darmstadt, GermanyCatch-up session09:50 Guiding catheters: shapes, length, side holes, approachEvald Høj Christiansen, Aarhus, DenmarkTerumo, your solution providerTerumo offers a comprehensive treatment solution for Chronic Total Occlusion:• Heartrail ® II - Large inner lumen PTCA guiding catheter• Runthrough ® NS - Impressive distal control PTCA Guide wire family• Finecross ® - Micro-Guide catheter designed for greater crossing success• Tazuna ® - Ultra low entry profile PTCA dilatation catheter ever madeFrom access to success... whenever you need them!IS405GB0413MDI10:05 Guide wires and microcatheters: when and how to use themNicolas Boudou, Toulouse, France10:20–10:50 Coffee break and exhibition7

The Experts „Live“Workshop 201310:50–12:55 Session 2Why and when treating CTO?Chairmen: Javier Escaned, Spain; Etsuo Tsuchikane, Japan;Emmanouil Brilakis, USA10:50 Mortality reduction? Yes? When?David Hildick-Smith, Brighton, UK11:05 CTO and acute coronary syndromesJ. P. Simao Henriques, Amsterdam, Netherlands11:20 Secondary revascularisation with CTO-PCI late post CABGHeinz Joachim Büttner, Bad Krozingen, GermanyComplex antegrade casesDiscussants: Omer Goktekin, Turkey; Bernward Lauer, Germany;Aigars Lismanis, Latvia; Didier Tchetche, France11:35 Case 3: LAD CTO in bifurcation: IVUS guided penetrationRoberto Garbo, Turin, Italy12:00 Case 4: Instent RCA CTO: radial approach and supportThierry Lefevre, Massy, FranceCatch-up session12:25 Star, mini-Star, angio guided Star …Mauro Carlino, Milan, Italy12:40 Antegrade dissection re-entry with the Bridgepoint System: why, where & howJames Spratt, Edinburgh, UK12:55–14:00 Lunch and exhibition14:00–16:15 Session 3Alternative techniques and practicals for antegrade approachChairmen: Thierry Lefevre, France; David Hildick-Smith, UK;Stephane Rinfret, CanadaDiscussants: Heinz Joachim Büttner, Germany; Michael Pieper, Switzerland;Gennaro Sardella; Italy14:00 Case 5: StingRay for a RCA CTOSimon Walsh, Belfast, Ireland14:30 Case 6: One radial and one snare for a LCx CTOGeorge Sianos, Thessaloniki, Greece15:00 CTO PCI for the antegrade-only operatorAntonio Serra, Barcelona, Spain15:15 How to size the stents? Difficulties? Role of imagingCarlo Di Mario, London, UK15:30 Specific technical aspects of instent CTOJavier Escaned, Madrid, SpainCatch-up session15:45 How to improve guiding catheter support?Stephane Rinfret, Quebec, Canada16:00 How to optimize retrograde collateral crossingOsamuh Katoh, Nagoya, Japan16:15–16:45 Coffee break and exhibition16:45–18:10 Session 4Short Stories 1Chairmen: George Sianos, Greece; Antonio Serra, Spain;Craig Thompson, USA16:45 Impact of residual RCA CTO after LM stentingAlaide Chieffo, Milan, Italy16:55 Innovative solutions for patients with severe renal failureThierry Lefevre, Massy, France17:05 What can we learn from a french Crossboss / Stingray experienceAlexandre Avran, Marseille, France17:15 A place for Laser in CTO PCI ?Peter O‘Kane, Bournemouth, UK17:25 Coregistration of MSCT in the cathlab for CTO PCIGerald Werner, Darmstadt, GermanyTechnical pearls17:35 Hydraulic retro CARTNicolas Boudou, Toulouse, France17:45 Guideliner place for CTO PCIKarl Isaaz, Saint Etienne, France17:55 Rotational atherectomy in the darkGennaro Sardella, Rome, Italy18:05 How to deal with extreme tortuosity of both groinsNicolaus Reifart, Bad Soden, Germany18:15 End of day 18 9

The Experts „Live“Workshop 2013Scientific ProgramSaturday, September, 28 th , 2013ReNAl DeNeRVATIoNComplex pCI8:00–10:15 Session 5CTO PCI strategiesChairmen: Gerald Werner, Darmstadt, Germany; Masahisa Yamane, Japan;James Spratt, UKControversy08:00 Japanese strategy for CTO PCI successMasahiko Ochiai, Tokyo, Japan08:10 Illustrated US algorithm for CTO PCI successCraig Thompson, Yale, USADRug - eluTINg sTeNTsAdvancingAnzeige New BOSTON Cardiology SCIENTIFICTogethersTRuCTuRAl HeART08:20 Discussion08:25 An attempt of ECC consensus on CTO PCI strategyNicolaus Reifart Bad Soden, Germany08:35 DiscussionSimple retrograde casesDiscussants: Hans Bonnier, Belgium; Valeri Gelev, Bulgaria; Karl Isaaz, France;Daniel Weilenmann, Switzerland08:40 Case 7: Simple retrograde RCA CTOYves Louvard, Massy, France09:10 Case 8: Rotablator for retrograde RCA approachJames Spratt, Edinburgh, UKCatch-up session09:40 CART, retro CART, stent assisted retro CART …Masahisa Yamane, Sayama City, Japan09:55 IVUS and CTO: guided penetration, reentry…Satoru Sumitsuji, Osaka, Japan10:10–10:40 Coffee break and exhibitionDispositifs médicaux, consultez les notices spécifiques à chacun pour plus d’information, 1303BSCPM003IC-149817-AA MAY2013 © 2013 Boston Scientific Corporation ou ses filiales. Tous droits réservés.11

The Experts „Live“Workshop 201310:40–13:05 Session 6Complex retrograde casesChairmen: Carlo Di Mario, UK; Anthony Gershlick, UK;Masahiko Ochiai, JapanDiscussants: Roberto Garbo, Italy; Artis Kalnins, Latvia;Markus Meyer-Gessner, Germany; Leszek Bryniarski, Poland10:40 Case 9: Complex retrograde approachAndrea Gagnor, Torino, Italy11:15 Case 10: Retrograde epicardial for a RCA CTOAlfredo Galassi, Catania, ItalyComplications11:50 First complicationDimitri Karmpaliotis, Atlanta, USA12:05 Atrial hematoma after retrogradeCarlo Di Mario, London, UK12:20 Coil embolizationRoberto Garbo,Turin,ItalyUnusual casesDiscussants: Nicolas Boudou, France; Evald Hoj Christiansen, Denmark;Andrea Gagnor, Italy; Jaroslaw Wojcik, Poland14:50 Case 11: One epicardic retrograde for two CTOsSatoru Sumitsuji, Osaka, Japan15:25 Case 12: Diagonal to Marginal retrograde approach for LCx CTOGerald Werner, Darmstadt, GermanyFuture of CTO PCI: learning, teaching, innovating16:00 How can I become a better CTO operatorGerald Werner, Darmstadt, Germany16:15 Operator experience and success rate of CTO PCI: lessonsYves Louvard, Massy, France16:30 ConclusionGerald Werner, Darmstadt, Germany17:00 Euro CTO Club General AssemblyCatch-up session12:35 Treatment of coronary perforations: material and techniquesJavier Escaned, Madrid, Spain12:50 X-Ray exposure: the difference between care and no-careCarlo Maccia, Bourg la Reine, France13:05–14:05 Lunch and exhibition14:05–16:30 Session7Short stories 2Chairmen: Alfredo Galassi, Italy; Dimitri Karmpaliotis, USA;Andrejs Erglis, Latvia14:05 Novel snare and pick up techniqueSatoru Sumitsuji, Osaka, Japan14:15 Retrograde approach Euro CTO registryAlfredo Galassi, Catania, Italy14:25 Is dissection reentry technique a predictor of CTO reocclusion?Emmanouil Brilakis, Dallas, USA14:35 J-Proctor long-term outcome after intimal vs. subintimal DESEtsuo Tsuchikane, Toyohashi, JapanINNOVATION DESIGNEDFOR HIGHLY STENOSED LESIONSSUPPORTValet ®MicrocatheterProprietary manufacturing processes helptake wire crossing support to the next levelVeriTorque technology and a shapeabletip provide precise guidewire control inchallenging anatomyGUIDANCEEagle Eye ® Platinum STDigital IVUS Catheter2.5 mm tip-to-transducer distance, theshortest availableAssess more of the vessel and branchwithout advancing as farFast, plug-and-play imaging with all of14:45 Discussionthe advantages of our top sellingEagle Eye ® Platinum Catheter12 13Find out more at www.volcanocorp.comVolcano and the Volcano logo are registered trademarks of Volcano Corporation. ©2013 Volcano Corporation. All rights reserved.

The Experts „Live“Workshop 2013EURO CTO CLUBPresidentGerald S. WernerMedizinische KlinikKlinikum DarmstadtDarmstadt, GermanyPresident electAlfredo R. GalassiCannizzaro HospitalUniversity of CataniaCatania, ItalyPast-PresidentNicolaus ReifartMain Taunus KlinikenBad Soden, GermanyBoardGeorge SianosAHEPA University HospitalThessaloniki, GreeceAnzeige BIOSENSORSBoardJavier EscanedSan Carlo HospitalMadrid, SpainBoardCarlo Di MarioNational Heart and Lung InstituteImperial College LondonLondon, UKTreasurerHans BonnierUniversity Hospital BrusselsBrussels, BelgiumCourse Directors 2013Yves LouvardInstitut Hospitalier Jacques CartierMassy, FranceThierry LefevreInstitut Hospitalier Jacques CartierMassy, FranceBioMatrix NeoFlex TM n’est pas commercialisé en France. Les informations relatives à ce produit ne sont pas destinées aux professionnels de santé exerçant en France.BioMatrix NeoFlex, BA9 and Biolimus A9 are trademarks or registered trademarks of Biosensors International Group, Ltd.Not available for sale in the United States and certain other countries.© 2013 Biosensors International Group, Ltd. All rights reserved.15

Club MembersAlexandre Avran, FranceHans Bonnier, BelgiumNicolas Boudou, FranceAlexander Bufe, GermanyHeinz Joachim Büttner, GermanyMauro Carlino, ItalyLeszek Bryniarski, PolandCarlo Di Mario, UKSimon El Hadad, FranceJavier Escaned, SpainAndrejs Erglis, LativaDariusz Dudek, PolandAlfredo R. Galassi, ItalyAndrea Gagnor, ItalyRoberto Garbo, ItalyAnthony Gershlick, UKOmer Goktekin, TurkeyTevfik Gürmen, TurkeyJan Harnek, SwedenGuy Heyndrickx, BelgiumDavid Hildick-Smith, UKEvald Høj Christiansen, DenmarkAssociated MembersEmanuele Barbato, BelgiumBernard Chevalier, FranceMauro De Benedictis, ItalyJavier Goicolea, SpainKarl-Eugen Hauptmann, GermanyHonorary MembersAntonio Colombo, ItalyJean Fajadet, FranceKarl Isaaz, FranceArtis Kalnins, LatviaJacques Koolen, NetherlandsBernward Lauer, GermanyThierry Lefevre, FranceAigars Lismanis, LatviaValeria Ljubenov Gelev, BulgariaYves Louvard, FranceVictoria Martin, SpainMarkus Meyer-Geßner, GermanyGöran Olivecrona, SwedenMichael Pieper, SwitzerlandNicolaus Reifart, GermanyGennaro Sardella, ItalyAntonio Serra, SpainGeorge Sianos, GreeceHorst Sievert, GermanyJames C. Spratt, UKDidier Tchetche, FanceLeif Thuesen, DenmarkDaniel Weilenmann, SwitzerlandGerald S. Werner, GermanyJarosław Wójcik, PolandDobri Hazarbasanov, BulgariaBernhard Reimers, ItalyJoachim Schofer, GermanyRalph Schulze, GermanyImhad Sheiban, ItalyJulian Strange, UKA91AX-9255-A2-EuroPCRImage courtesy of AZ Maria Middelares, Ghent, Belgiumwww.siemens.com/artis-q-familyThe Artis Q and Artis Q.zen, our newproduct lines for interventional imaging,are visionary breakthroughs in X-raygeneration and detection taking performance,precision, and sensitivity to thenext level.Both systems offer unparalleled performancewith a new X-ray tube entirelydeveloped around the unique flat emittertechnology. What’s more, with theArtis Q.zen we introduce the crystallinesilicon detector, a groundbreaking newdetector technology that results in enhancedsensitivity at ultra-low-dose levels.Anzeige MEDTRONICSee this while you areplacing your deviceReal-time. With CLEARstent LiveIn the fight against the most threateningdiseases like coronary artery disease,the Artis Q and Artis Q.zen come withinnovative applications to support preciseguidance during interventional procedures.With CLEARstent Live for example, stentsare imaged in real-time during therapy,with motion stabilization created by simultaneouscorrection for the heartbeat.Artis Q and Artis Q.zen – experience thefuture of interventional imaging.16The Euro CTO Club cordially thanks the invited speakers for supportingthe Workshop with their knowledge and expertise:Brilakis, Emmanouil, USAChieffo, Alaide, ItalyHenriques, José P.S., NetherlandsKarmpaliotis, Dimitrios, USAMaccia, Carlo, FranceOchiai, Masahiko, JapanO’Kane, Peter, UKRinfret, Stephane, CanadaSumitsuji, Satoru, JapanThompson, Craig, USATsuchikane, Etsuo, JapanYamane, Masahisa, JapanAnswers for life.

The Experts „Live“Workshop 2013EURO CTO CLUB - STATISTICSEuro CTO Club membership6055525043403833293021201310EURO CTO CLUB - STATISTICSRetrograde Aproach/all CTO(all operators – 50% at < 10%)302520151011 10 11% of all CTO17252702006 2007 2008 2009 2010 2011 2012 2013Requirements: experience of 300 CTO and 50 / year502008 2009 2010 2011 2012 2013300025002000150010005000Online Registry 2008-20122634 26032189172413032008 2009 2010 2011 20121009080706050403020100SuccessAntegrade vs Retrograde85 8288 89 90 9168 71662011 2012 2013AntegrdeRetrogradeCombined18 19

The Experts „Live“Workshop 2013EURO CTO CLUB - STATISTICSSuccess Retrograde related toexperience (all cases)EURO CTO CLUB - STATISTICSAnte - versus Retrograde2011 - 13100908070605040302010597840035030025020015010050296515487356261ante (4832)retro (634)0< 10% RA >10% RA0Fluoro (min) Procedure (min) Dye (ml)20 21

GE HealthcareEmpoweringcritical thinkingInnova IGS 520Can imagingtechnologies change the wayyou perform your CTO procedures?Anzeige BRIDGEPOINTCTO procedures can be time-consuming andresource-intensive. Estimating the occlusion length andpath, visualizing the entry and trajectory of the coronary withthe added challenge of side branch overlay, and assessingplaque constituents and the location of the calcification allrequire high contrast use and dose for the patient. That’sespecially true when imaging requires visualization in oneangle over extended periods. But what if imaging technologiescould help you better identify and visualize the occlusion?What if they could help you find the optimal view quicklyand prevent high radiation exposure during the procedure?Discover how smart imaging empowers you with the tools totreat your patients with greater clarity.GE imagination at workThe Experts „Live“Workshop 2013General Information5th Experts "Live" Workshop 2013September, 27 th -28 th , 2013Paris, FranceVenueHotel Pullman Paris-Montparnasse19 Rue Commandant René Mouchotte | 75014 Paris | FranceLanguageThe official language of the congress is English. No simultaneous translation is available.Certificate of AttendanceThe Certificate of Attendance will be available on-site at the conference desk.The meeting is accredited by the European Board of Accreditation in Cardiology (EBAC).Registration750,00 € incl. VAT350,00 € incl. VAT discounted rate for fellows*The Registration for the Conference includes:- Receipt of the badge of the conference bag- Attendance of the conference proceedings- Catering during the conference- Receipt of the participation certificate* Letter from supervisor needed at the time of registrationOnline registration: www.eurocto2013.comScientific OrganisationThierry Lefèvre, FranceYves Louvard, FranceGerald S. Werner, GermanyCongress Organisationwikonect GmbHHagenauer Strasse 53 | 65203 Wiesbaden, GermanyTel.: +49 (0) 611 204 809 0 | Fax: +49 (0) 611 204 809 10eMail: info@wikonect.de | www.wikonect.de23

The Experts „Live“Workshop 2013We thank the following companies for their support!Platinum SponsorSilver SponsorGold SponsorSponsorACIST Medical SystemsAcrostak AGMedtronic24 25

ImprintEuro CTO ClubCourse DirectorsThierry Lefevre and Yves Louvard,Massy, FranceScientific BoardGerald S. WernerDarmstadt, GermanyNicolaus ReifartBad Soden, GermanyAlfredo R. GalassiCatania, ItalyHans BonnierBrussels, BelgiumGeorge SianosThessaloniki, GreeceJavier EscanedMadrid, SpainCongress agency / Organizerwikonect GmbHHagenauer Str. 5365203 Wiesbaden, Germany26

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