14th Experts Live CTO
September 2nd - 3rd, 2022 - Mainz, Germany
AGIK Parallel Session - Session 1:
The 101 of the global consensus approaches
The 3 “?” of CTO-PCI: When? Why? Who?
Alexaner Bufe, Krefeld, Germany
Room:
West Foyer - Friday 09:30
Chairmen:
Thomas Schmitz, Essen, Germany;
Heinz Joachim Büttner, Bad Krozingen, Germany
15th Experts Live CTO - Carlo Di Mario: ConclusionsEuro CTO Club
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Francesco Burzotta: Wrap up Gemelli CasesEuro CTO Club
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Jonathan Hill: Role of mechanica support in CTO recanalizationEuro CTO Club
10:42
Role of mechanica support in CTO recanalization
Jonathan Hill (London - UK)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Gregor Leibundgut: Role of DEB in CTO-PCIEuro CTO Club
10:35 Role of DEB in CTO-PCI
Gregor Leibundgut (Basel - CH)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
15th Experts Live CTO - Carlo Di Mario: ConclusionsEuro CTO Club
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Francesco Burzotta: Wrap up Gemelli CasesEuro CTO Club
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Jonathan Hill: Role of mechanica support in CTO recanalizationEuro CTO Club
10:42
Role of mechanica support in CTO recanalization
Jonathan Hill (London - UK)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Gregor Leibundgut: Role of DEB in CTO-PCIEuro CTO Club
10:35 Role of DEB in CTO-PCI
Gregor Leibundgut (Basel - CH)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Kambis Mashayekhi: EuroCTO Consensus on treatment of Calcified CTO lesion Eur...Euro CTO Club
AUDITORIUM ZUBIN MEHTA
08/09/2023 04:30 - 05:20
PLENARY SESSION - INTERVENTIONAL CTO & CHIP RESEARCH Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Emmanouil S. Brilakis - CTO PCI Outcome associated with poor quality of the d...Euro CTO Club
16:53
CTO PCI Outcome associated with poor quality of the distal target vessel
Emmanouil Brilakis (Minneapolis - USA)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Mario Iannaccone - 2 EuroCTO Consensus on Guide Catheter Extensions JACC Card...Euro CTO Club
16:33
EuroCTO Consensus on Guide Catheter Extensions JACC Cardiovasc Interventions
Mario Iannaccone (Turin)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
15th Experts Live CTO: Emmanouil S. Brilakis - The Year in CTO research & pra...Euro CTO Club
15th Experts "Live" CTO: Auditorium Zubin Mehta - Friday 08:00
15th Experts Live CTO: Opening Session
PLENARY - OPENING SESSION
08:29
The Year in CTO research & practice
Emmanouil Brilakis (Minneapolis - USA)
___________________________________________
PLENARY - OPENING SESSION
Auditorium Zubin Mehta - Friday 8:00 - 9:00
Chairpersons:
Antonio Colombo (Milan),
Giovanni Esposito (Naples)
Discussants:
John Davies (Basildon - UK),
Marco Hautmann (Essen - D),
Aravinda Nanjundappa (Cleveland - USA)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
If you want to know all the details of the event, click on the image below to download the final program, where you will be able to orient yourself on the day, time and place of a specific video recorded at 15th Experts Live CTO.
15th Experts Live CTO: Opening Session - Emanuele BarbatoEuro CTO Club
15th Experts "Live" CTO: Auditorium Zubin Mehta - Friday 08:00
15th Experts Live CTO: Opening Session
PLENARY - OPENING SESSION
08:05
CTO in the Revascularization Guidelines
Emanuele Barbato (Rome)
___________________________________________
PLENARY - OPENING SESSION
Auditorium Zubin Mehta - Friday 8:00 - 9:00
Chairpersons:
Antonio Colombo (Milan),
Giovanni Esposito (Naples)
Discussants:
John Davies (Basildon - UK),
Marco Hautmann (Essen - D),
Aravinda Nanjundappa (Cleveland - USA)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
If you want to know all the details of the event, click on the image below to download the final program, where you will be able to orient yourself on the day, time and place of a specific video recorded at 15th Experts Live CTO.
15th Experts Live CTO: Opening Session - Carlo Di MarioEuro CTO Club
15th Experts "Live" CTO: Auditorium Zubin Mehta - Friday 08:00
15th Experts Live CTO: Opening Session
PLENARY - OPENING SESSION
08:00
Introduction
Carlo Di Mario (Florence)
___________________________________________
PLENARY - OPENING SESSION
Auditorium Zubin Mehta - Friday 8:00 - 9:00
Chairpersons:
Antonio Colombo (Milan),
Giovanni Esposito (Naples)
Discussants:
John Davies (Basildon - UK),
Marco Hautmann (Essen - D),
Aravinda Nanjundappa (Cleveland - USA)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
If you want to know all the details of the event, click on the image below to download the final program, where you will be able to orient yourself on the day, time and place of a specific video recorded at 15th Experts Live CTO.
Kambis Mashayekhi: EuroCTO Consensus on treatment of Calcified CTO lesion Eur...Euro CTO Club
AUDITORIUM ZUBIN MEHTA
08/09/2023 04:30 - 05:20
PLENARY SESSION - INTERVENTIONAL CTO & CHIP RESEARCH Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Emmanouil S. Brilakis - CTO PCI Outcome associated with poor quality of the d...Euro CTO Club
16:53
CTO PCI Outcome associated with poor quality of the distal target vessel
Emmanouil Brilakis (Minneapolis - USA)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Mario Iannaccone - 2 EuroCTO Consensus on Guide Catheter Extensions JACC Card...Euro CTO Club
16:33
EuroCTO Consensus on Guide Catheter Extensions JACC Cardiovasc Interventions
Mario Iannaccone (Turin)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
15th Experts Live CTO: Emmanouil S. Brilakis - The Year in CTO research & pra...Euro CTO Club
15th Experts "Live" CTO: Auditorium Zubin Mehta - Friday 08:00
15th Experts Live CTO: Opening Session
PLENARY - OPENING SESSION
08:29
The Year in CTO research & practice
Emmanouil Brilakis (Minneapolis - USA)
___________________________________________
PLENARY - OPENING SESSION
Auditorium Zubin Mehta - Friday 8:00 - 9:00
Chairpersons:
Antonio Colombo (Milan),
Giovanni Esposito (Naples)
Discussants:
John Davies (Basildon - UK),
Marco Hautmann (Essen - D),
Aravinda Nanjundappa (Cleveland - USA)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
If you want to know all the details of the event, click on the image below to download the final program, where you will be able to orient yourself on the day, time and place of a specific video recorded at 15th Experts Live CTO.
15th Experts Live CTO: Opening Session - Emanuele BarbatoEuro CTO Club
15th Experts "Live" CTO: Auditorium Zubin Mehta - Friday 08:00
15th Experts Live CTO: Opening Session
PLENARY - OPENING SESSION
08:05
CTO in the Revascularization Guidelines
Emanuele Barbato (Rome)
___________________________________________
PLENARY - OPENING SESSION
Auditorium Zubin Mehta - Friday 8:00 - 9:00
Chairpersons:
Antonio Colombo (Milan),
Giovanni Esposito (Naples)
Discussants:
John Davies (Basildon - UK),
Marco Hautmann (Essen - D),
Aravinda Nanjundappa (Cleveland - USA)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
If you want to know all the details of the event, click on the image below to download the final program, where you will be able to orient yourself on the day, time and place of a specific video recorded at 15th Experts Live CTO.
15th Experts Live CTO: Opening Session - Carlo Di MarioEuro CTO Club
15th Experts "Live" CTO: Auditorium Zubin Mehta - Friday 08:00
15th Experts Live CTO: Opening Session
PLENARY - OPENING SESSION
08:00
Introduction
Carlo Di Mario (Florence)
___________________________________________
PLENARY - OPENING SESSION
Auditorium Zubin Mehta - Friday 8:00 - 9:00
Chairpersons:
Antonio Colombo (Milan),
Giovanni Esposito (Naples)
Discussants:
John Davies (Basildon - UK),
Marco Hautmann (Essen - D),
Aravinda Nanjundappa (Cleveland - USA)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
If you want to know all the details of the event, click on the image below to download the final program, where you will be able to orient yourself on the day, time and place of a specific video recorded at 15th Experts Live CTO.
4. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Grüntzig 1985:
“If we cannot solve the total
closure problem, we probably will
never really address the question
of multivessel dilatation“
5. What is a CTO ?
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
6. RCA-CTO
collaterals
TIMI 0/I
Occlusion duration > 3 months
Di Mario et al., EuroIntervention 2007;3:30-43 A.Bufe - EuroCTO Club/AGIK 2022 Mainz
7. When and Why
should we recanalize
a CTO ?
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
11. RCA-CTO
collaterals
TIMI 0/I
Occlusion duration > 3 months
PAo
POccl APVOccl
RColl
RP
PAo
POccl APVOccl
RColl
Pressure/
Doppler Wire
Pressure/
Doppler Wire
Before recanalization Reocclusion after PTCA
TCO Balloon
RA RA
RP
Werner et al., EHJ 2006;27:2406-12
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
12. n = 1000
Success rate
86%
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Sapontis et al., JACC Cariovasc Intv 2017
17. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
1 vessel disease
Patient is severely
symptomatic, AP CCS III
Normal LV-function
Do we really need
ischaemia test?
22. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
4 years MACCE-Rate was
sign. lower in CR-group
compared to ICR-group
CR = complete revascularization
ICR = incomplete revaskularization
Farooq et al., JACC 2013;61:282-94
PCI
CABG
Complete Revascularization
Independant predictor for incomplete
revaskularisation was the existence of a CTO
51% recanalization success rate
23. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Garcia et al., J Am Coll Cardiol 2013;62:1421-31
35 Studies
PCI
IR
56%
CABG
IR
25%
33. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Prerequisite: Experienced operator (complex coronary interventions,
bifurcations, left main, AMI, rotablation, IVUS, mother and child, micros,
wires, complication management…)
Attend CTO workshops, dedicated CTO sessions, live cases
work with a proctor
you need time and patience, good team and two cathlabs
Do at least 50 cases a year
Operators with more than 100 cases/year achieve highest success rates
Refer to a specialized center if you cannot adress the problem
40. Eine CTO-Rekanalisation führt zu einer nachhaltigen Reduktion/Beseitigung
von Angina pectoris und Dyspnoe und verbessert die Belastbarkeit (besser
als OMT) und gelingt in spezialisierten Zentren zu 90%
bei einer Mehr-GE muss interventionell meist eine komplette
Revaskularisation erreicht werden (residueller Syntax-Score < 9)
bei einer Mehr-GE mit CTO sollte im Heart Team und Patienten besprochen
werden, ob PCI vs Bypass-OP vs Hybrid-Verfahren
Zusammenfassung
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
77. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
• die 4 Jahres MACCE-Rate war
sign. geringer in der CR-Gruppe
als in der ICR-Gruppe
CR = komplette Revaskularisation
ICR = inkomplette Revaskularisation
Farooq et al., JACC 2013;61:282-94
CABG
88. EURO-CTO Study
Success Failure
Decision as per usual
clinical care
Medical Rx CABG
Ongoing angina
despite OMT*
Clinically
indicated
interim PCI
Repeat Exercice Tolerance Test (ETT) for objective assessment of ischaemia @ 12m and 36months
Single-vessel disease CTO only
Multivessel CAD including CTO
Treat non-occlusive disease by
PCI before CTO with DES
Angina or
angina-
equivalent
symptoms
Randomisation 2:1
PCI with DES
+ OMT
n=800
2
OMT to include:
- Aspirin,
- Statin,
- ACE-inhibitor where tolerated
- + up to 2 anti-anginal agents at
max tolerated dose including rate-
limiting agent where appropriate.
Ischaemic symptoms should be
confirmed with non-invasive test.
OMT
n=400
1
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Efficacy: Quality of Life @ 12 and 36 months
Safety: Death, non-fatal myocardial infarction (ITT, PP) @ 36 months
97. Christakopoulos G., Brilakis, ES., Am J Cardiol 2015
Effect of successful vs. failed CTO recanalisation on
all-cause mortality during follow up
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
98. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
n = 1162
Cardiac death Suden Cardiac death/
Sus. VTs
Godino et al., BMJ 2019
99. • die 4 Jahres MACCE-Rate war
sign. geringer in der CR-Gruppe
als in der ICR-Gruppe
• der stärkste unabhängige
Prädiktor für eine inkomplette
Revaskularisation war das
Vorhandensein einer CTO,
51% Reka-Erfolgsrate
CR = komplette Revaskularisation
ICR = inkomplette Revaskularisation
Farooq et al., JACC 2013;61:282-94
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
100. Garcia et al., J Am Coll Cardiol 2013;62:1421-31
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
104. ..führt zu einer nachhaltigen Reduktion/Beseitigung von Angina pectoris und
Dyspnoe und verbessert die Belastbarkeit (besser als OMT)
..erreicht eine komplette Revaskularisation bei Mehr-GE und führt zu
einem besseren Outcome als eine inkomplette Behandlung
..vermeidet oft eine Bypass-Operation oder Re-Operation
Unter Anwendung moderner ante- und retrograder Techniken können
Erfolgsraten von 90% erreicht werden bei geringer Komplikationsrate
Eine erfolgreiche CTO-Rekanalisation
bei Beschwerden und Viabilität…
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
105. Titelmasterformat durch
Klicken bearbeiten
EURO CTO CLUB
Berlin 2020
›› 12th Experts "Live"
CTO Workshop 2020
September 11th – 12th, 2020
Berlin, Germany
www.eurocto.eu
SAVE THE DATE
Vielen Dank!
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
107. • die 4 Jahres MACCE-Rate war
sign. geringer in der CR-Gruppe
als in der ICR-Gruppe
CR = komplette Revaskularisation
ICR = inkomplette Revaskularisation
Farooq et al., JACC 2013;61:282-94
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
119. EURO-CTO Study
Success Failure
Decision as per usual
clinical care
Medical Rx CABG
Ongoing angina
despite OMT*
Clinically
indicated
interim PCI
Repeat Exercice Tolerance Test (ETT) for objective assessment of ischaemia @ 12m and 36months
Single-vessel disease CTO only
Multivessel CAD including CTO
Treat non-occlusive disease by
PCI before CTO with DES
Angina or
angina-
equivalent
symptoms
Randomisation 2:1
PCI with DES
+ OMT
n=800
2
OMT to include:
- Aspirin,
- Statin,
- ACE-inhibitor where tolerated
- + up to 2 anti-anginal agents at
max tolerated dose including rate-
limiting agent where appropriate.
Ischaemic symptoms should be
confirmed with non-invasive test.
OMT
n=400
1
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Efficacy: Quality of Life @ 12 and 36 months
Safety: Death, non-fatal myocardial infarction (ITT, PP) @ 36 months
130. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
6.389 patients
Revascularization was associated
with a protective effect only in the
subset of extensive CMR-related
ischaemia
Extensive ischaemic burden was
related to a higher risc of long term
mortality
516/516
matched
patients
150. Christakopoulos G., Brilakis, ES., Am J Cardiol 2015
Effect of successful vs. failed CTO recanalisation on
all-cause mortality during follow up
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
151. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
n = 1162
Cardiac death Suden Cardiac death/
Sus. VTs
Godino et al., BMJ 2019
152. • die 4 Jahres MACCE-Rate war
sign. geringer in der CR-Gruppe
als in der ICR-Gruppe
• der stärkste unabhängige
Prädiktor für eine inkomplette
Revaskularisation war das
Vorhandensein einer CTO,
51% Reka-Erfolgsrate
CR = komplette Revaskularisation
ICR = inkomplette Revaskularisation
Farooq et al., JACC 2013;61:282-94
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
153. Titelmasterformat durch
Klicken bearbeiten
›› 12th Experts "Live"
CTO Workshop 2020
September 11th – 12th, 2020
Berlin, Germany
www.eurocto.eu
SAVE THE DATE
Vielen Dank!
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
155. • die 4 Jahres MACCE-Rate war
sign. geringer in der CR-Gruppe
als in der ICR-Gruppe
CR = komplette Revaskularisation
ICR = inkomplette Revaskularisation
Farooq et al., JACC 2013;61:282-94
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
160. ..führt zu einer nachhaltigen Reduktion/Beseitigung von Angina pectoris und
Dyspnoe und verbessert die Belastbarkeit (besser als OMT)
..erreicht eine komplette Revaskularisation bei Mehr-GE und führt zu
einem besseren Outcome als eine inkomplette Behandlung
..vermeidet oft eine Bypass-Operation oder Re-Operation
Unter Anwendung moderner ante- und retrograder Techniken können
Erfolgsraten von 90% erreicht werden bei geringer Komplikationsrate
Eine erfolgreiche CTO-Rekanalisation
bei Beschwerden und Viabilität…
A.Bufe - EuroCTO Club/AGIK 2022 Mainz
161. A.Bufe - EuroCTO Club/AGIK 2022 Mainz
Bangalore et al., Circulation 2020; 142:841-857
n = 14877
death
