12th AHO CTO PCI Meeting 2020 (Almost Hands-On CTO PCI Course)

Advanced Chronic Total Occlusion (CTO) PCI Training Program

Overview

The 12th AHO (Almost Hands-On) CTO PCI Meeting 2020, organized in collaboration with Simple Education, is a specialized interventional cardiology course dedicated to the contemporary management of Coronary Chronic Total Occlusions (CTO). Designed as a virtual “Almost Hands-On” workshop, the program combines expert lectures, structured CTO algorithms, practical procedural tips, and detailed case reviews to provide a comprehensive understanding of CTO recanalization techniques.

Through a series of pre-recorded live cases, expert discussions, and master classes, participants gain practical insights into antegrade and retrograde CTO strategies, lesion assessment, procedural planning, equipment selection, and complication avoidance. The course focuses on translating advanced CTO PCI techniques into real-world clinical practice.

The workshop was held on December 15, 2020, bringing together internationally recognized CTO operators and educators to discuss modern approaches to complex coronary interventions.

Course Specifications

Format

• Video Lectures
• Case-Based Learning
• Expert Panel Discussions
• CTO PCI Master Classes

Course Date

December 15, 2020

Educational Level

Advanced

Specialty

Interventional Cardiology

Learning Objectives

Upon completion of this course, participants should be able to:

• Evaluate patients for CTO PCI candidacy.
• Stratify CTO lesion complexity using established scoring systems.
• Select appropriate revascularization strategies.
• Understand antegrade and retrograde CTO crossing techniques.
• Apply contemporary CTO algorithms effectively.
• Optimize procedural planning and equipment selection.
• Manage challenging CTO anatomies.
• Improve procedural success rates while minimizing complications.
• Recognize indications for dissection and re-entry techniques.
• Enhance decision-making during complex CTO interventions.

Course Curriculum

Session 1: Review of Previous Cases

Last Year Cases – What Happened?

A review of previously presented CTO interventions with discussion of:

• Long-term outcomes
• Procedural successes
• Complications encountered
• Lessons learned

Patient Selection and CTO Complexity

Patient Selection and Stratifying CTO Complexity

Topics include:

• Clinical indications for CTO PCI
• Symptom assessment
• Ischemia evaluation
• Viability testing
• J-CTO score
• PROGRESS CTO score
• Procedural risk assessment

Participants learn how to identify patients most likely to benefit from CTO revascularization.

Antegrade CTO Strategies

Antegrade Case: Live in a Box

Hospital Clínico San Carlos

A detailed step-by-step review of a real CTO intervention demonstrating:

• Lesion analysis
• Wire escalation techniques
• Device selection
• Procedural workflow

My Five Tips in Antegrade Approach

Practical guidance covering:

• Guide catheter selection
• Wire escalation strategies
• Microcatheter utilization
• Lesion crossing techniques
• Troubleshooting difficult lesions

Discussion Session 1

Interactive faculty discussion analyzing antegrade CTO techniques and procedural decision-making.

Retrograde CTO Strategies

Straightforward Retrograde CTO

Review of successful retrograde CTO recanalization.

Topics include:

• Collateral selection
• Septal crossing
• Epicardial collateral techniques
• Retrograde wire manipulation

Five Tips for a Successful Retrograde Approach

Key procedural pearls covering:

• Collateral channel assessment
• Safety considerations
• Equipment optimization
• Reverse CART strategies
• Complication avoidance

Discussion Session 2

Faculty review of retrograde CTO techniques and clinical decision pathways.

CTO Equipment and Materials

Ingredients Required for Successful CTO PCI

Comprehensive review of:

Guidewires

• Soft polymer wires
• Penetration wires
• Dedicated CTO wires

Microcatheters

• Finecross
• Corsair
• Turnpike

Support Devices

• Guide extensions
• Re-entry systems
• Balloon technologies

Participants learn how to build an efficient CTO toolkit.

Expert Master Classes

Improvements in Antegrade Dissection and Re-Entry

Advanced techniques for:

• Controlled dissection
• Re-entry strategies
• Stingray system utilization
• Subintimal tracking

Faculty discuss how newer technologies have improved success rates.

Discussion Session 3 – Day 1

Case-based review and audience interaction.

CTO Algorithms

Which Algorithm, When, and How They Compare

Detailed review of:

• Hybrid CTO Algorithm
• EuroCTO Algorithm
• Asia-Pacific CTO Algorithm
• PROGRESS CTO Approach

Participants learn how to select the most appropriate strategy for individual lesion characteristics.

Complex Antegrade CTO PCI

Complex Antegrade Cases

Advanced case demonstrations involving:

• Long lesions
• Calcified occlusions
• Ambiguous proximal caps
• Bifurcation CTOs

Five Tips in Complex Antegrade Approach

Expert recommendations for managing difficult CTO anatomy and procedural challenges.

Discussion Session 1 – Day 2

Interactive review of complex antegrade interventions.

Advanced Retrograde Techniques

Retrograde Case Presentation

Detailed procedural walkthrough demonstrating:

• Complex collateral crossing
• Reverse CART
• Externalization techniques
• Successful CTO recanalization

Five Tips for a Successful Complex Retrograde Approach

Topics include:

• Epicardial collateral safety
• Channel selection
• Wire escalation
• Equipment support
• Bailout strategies

Discussion Session 2 – Day 2

Expert analysis of advanced retrograde interventions.

Master Class: Improvements in Retrograde CTO PCI

Comprehensive review of:

• Contemporary retrograde techniques
• New device technologies
• Improved procedural algorithms
• Future directions in CTO intervention

Final Discussion and Wrap-Up

Summary of key learning points including:

• CTO planning
• Antegrade versus retrograde decision-making
• Equipment optimization
• Complication management
• Procedural efficiency

Educational Features

Real-World Case Demonstrations

Participants observe complete CTO interventions performed by expert operators.

Practical Procedural Tips

Each faculty member shares practical techniques that can immediately improve clinical outcomes.

Algorithm-Based Learning

Focuses on structured decision-making for CTO PCI.

Interactive Discussions

Faculty panels provide insight into complex clinical scenarios and troubleshooting strategies.

Target Audience

Physicians

• Interventional Cardiologists
• Clinical Cardiologists
• Coronary Intervention Specialists

Trainees

• Interventional Cardiology Fellows
• Cardiology Fellows
• Advanced Coronary Intervention Trainees

Allied Health Professionals

• Cath Lab Technologists
• Cardiovascular Nurses
• Radiographers involved in PCI procedures

Why This Course Stands Out

Dedicated CTO PCI Education

Focused exclusively on chronic total occlusion intervention.

Expert International Faculty

Features experienced CTO operators sharing practical procedural insights.

Comprehensive Technique Coverage

Covers antegrade, retrograde, dissection/re-entry, and hybrid approaches.

Case-Based Learning

Real procedural demonstrations reinforce theoretical concepts.

High Clinical Relevance

Designed to improve procedural success and operator confidence in CTO PCI.