CTO Workshop and Proctorship by Dr. Sumitsuji in National CV Center Harapan Kita

January 25, 2018

picture CTO Workshop and Proctorship by Dr. Sumitsuji in National CV Center Harapan Kita

Chronic total occlusion (CTO) is a challenging lesion subset, and have been plagued with difficulties - including inability to cross the lesion and deliver stents, increased use of resources, and up to 2 times the procedure and fluoroscopy time compared with non-CTO percutaneous coronary intervention (PCI). The prevalence has been described as high as 30%, and 13% of cases exhibit more than one CTO. Increased failure rates, technical complexity, cost (of equipment, manpower) and procedure length have historically discouraged percutaneous revascularization attempts. Thus, National Cardiovascular Center of Harapan Kita, Jakarta as one of the referral center in Indonesia for complex cases, collaborated with Indonesia Society of Coronary Intervention facilitate interventional cardiologist to escalate coronary intervention skill and widen the concept of CTO from experts all over the world. One of endowed chair professor from Osaka University, Satoru Sumitsuji, MD, has been invited to give lecture and as a proctor in National Cardiovascular Center of Harapan Kita, Jakarta, from 21st to 22nd January 2018. He is one of the professor in Cardiology for Interventional Education and Research, that dedicates himself in dealing with CTO cases, and for the past 10 years he was invited to give lecture and proctorship all over the world. He was giving lecture about Newtonian perspective in coronary intervention especially in CTO cases and modified jailed balloon as one of the important step to keep the stent strut well opposed on the vessel wall in bifurcation lesion. He also performed live demo of 4 patients of which he showed different technique in each case. Using IVUS as a guidance through one guide catheter and inflated balloon with J-tip guide wire surround it through another guide catheter as an anchor to give extra backup are key factors of successful PCI in CTO. He also showed anterograde technique continued with retrograde technique in double CTO cases and performed one of technique in bifurcation lesion i.e modified jailed balloon to prevent the stent strut deformation. With the emergence of novel techniques and advanced equipment, technical difficulties have become much less limiting. Operators trained in the CTO treatment algorithm with the mentorship of an expert can become successful using these advanced strategies. Contemporary appropriateness criteria, coupled with safety guidelines, have commenced a new era of percutaneous intervention, targeting a well-defined subset with groundbreaking ideas and technology. (Probi)