June 19th, 2012

C3 (Complex Cardiovascular Catheter Therapeutics) 2012

Greetings from Orlando, Florida! I am in town for the C3 therapeutics global summit being held at the Rosen Shingle Creek Resort. This afternoon had some very interesting topics for interventionalists and fellows-in-training. I attended a preconference symposium, Imaging: Moving Beyond Angiography.

Throughout the first year of fellowship, I recall multiple cases where angiography alone failed to show how critical coronary artery stenosis can be. I found the information provided today to be very high yield, especially for those in training. For example, I have used intravascular ultrasound (IVUS) several times this past year, and the presenters did an excellent job discussing the essentials of IVUS interpretation. The symposium also covered fractional flow reserve in great detail. A panel of cardiologists discussed FFR evaluation of special lesions, including LM, tandem lesions, non-LM bifurcation, diffuse disease, and SVG. A discussion on interpretation of optical coherence tomography (OCT) followed. I learned a great deal as I had not seen this technology used before in a live cath lab setting.

A live case transmission from the Sanjay Gandhi Postgraduate Institute for Medical Sciences in Lucknow, India, concluded the session. The case was a patient with triple vessel disease including a CTO LAD lesion, an ostial and mid Cx stenosis, and a PDA stenosis.  The cardiologist on the case chose to perform PCI to the CTO lesion, but the amazing part is that he crossed using a retrograde technique via a diagonal collateral!  The physicians implemented both IVUS and OCT in this case, which made for a great review of their respective uses.  A very interesting case indeed!

After a break for dinner and a reception, I attended Innovation in Endovascular Technology in the Treatment of Peripheral CTOs. I was fascinated by the ingenuity used to open some of these complex peripheral CTO lesions.  Methods of CTO crossing via subintimal recanalization versus true lumen crossing as well as new tools and techniques were discussed.

Tomorrow promises to be another great day of topics.  I will keep you posted!

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