Putting the patient first in coronary chronic total occlusions

Despite recent advances in PCI capabilities, we should remember that whatever the possible treatment options are, the patient’s interests must come first when deciding a treatment strategy. This applies especially when considering catheterisation of coronary CTO and this concept will be reinforced in today′s Focus session, sponsored by Abbott Vascular and chaired by Masahisa Yamane of Japan. This session will have something for all levels of experience, from junior doctors learning the basics, to senior experienced practitioners interested to learn about complex cases. This broad spread of valuable information will be accomplished by the use of two separate recorded cases – one an uncomplicated CTO patient and one an edited film of what turned out to be a complex 3-hour recanalisation, exploring the frontiers of what is possible with this procedure.

The session will start with an uncomplicated case presentation from Massy, after which Jochen Wohrle will describe the basic clinical rationale and indications for recanalising chronic CTO, and the benefits of doing so. Martine Gilard will build a discussion of the role of imaging in the planning and guidance of coronary CTO interventions. The angiogram can provide crucial pre- and peri-operative information to ensure a successful process and optimal outcomes and there will be practical advice on how to perform and read the imaging aspects.

Senior attendees will gain much from the next presentation on common complications and how best to handle them, given by Flavio Airoldi, which will lead into the edited complex CTO presentation from Aalst. Summing up, Masahisa Yamane will reinforce the take-home messages about the procedures indications, the role of imaging and above all the need to keep the patient′s best interest uppermost at all times.