JIM Today 2018 - Saturday - page 2

2
JIM today
Issue 3 
Saturday
 24 February 2018
Live cases from Bonn Germany 
Main Hall Washington 
Thursday 
14:30
catheters over the next
one to two years.”
Back to the procedure at hand, Dr Kao discussed
crossing approach: “For this kind of lesion wire
crossing, either retrograde or antegrade, is very
unlikely. So we are prepared to do a reverse-CART if
we have to. Then we will focus on
achieving regular wire crossing.”
From the JIM floor, session chair
Martin B Leon commented: “Not
every hospital has these expert
CTO operators. This, I think, would
have been a good case for LIMA
[left internal mammary artery] to
LAD. This would be an option if
you didn’t have the ability to do it
like this.”
On the retrograde active wire,
a Gaia II (Asahi Intecc), Dr Leon commented: “This
has become very popular for CTO operators as part
of the armamentarium. It certainly began as an an-
tegrade crossing wire but is now being used more
and more retrogradely.”
Delegates took a short break to watch a
segment from a different live case. Dr Kao then
returned to describe highlights of the procedural
strategy adopted in this case. The CTO’s proximal
cap was hard, he said, demanding control of wire
direction to prevent deflection into subintimal
space. “This is why we wanted to use the Gaia II,
which is more directional,” he said. “Even when we
end up in the subintimal space, we can still correct
its position.”
After wire penetration was
achieved, and the retrograde
system was removed, IVUS was
carried out to assess procedural
results: “I would always do IVUS
for these ostial LADs just to see
if you were true-to-true,” said
Dr Leon.
“We want to know first of
all our wire position,” added
Dr Kao. “We want to know the
distal landing zone. We want to
know whether the LAD ostium has been touched
or not.”
Describing the stenting procedure and sizing, Dr
Kao said: “These days I just look at cross-sectional
area. Drug-eluting stents are so good at inhibiting
neointimal hyperplasia that you don’t really have to
go for external elastic membrane (EM) to EM – that
would be too stressful for the vessels.”
Dr Leon added: “That was a good choice. In
Live cases showcase procedural
Programme
Saturday, February 24, 2018
Main Hall Washington
Chairpersons of the day: Eberhard Grube,
Martin B. Leon
8.30
LIVE CASES FROM MILAN, ITALY
Columbus Hospital
Commentators: Anand Gnanaraj, Ghada Mikhail,
Issam Moussa, Mohamed Ahmed Sobhy,
Ferdinando Varbella
Guest operator: Sunao Nakamura
Online factoids relevant to the cases presented:
Lorenzo Azzalini (Coordinator), Marco
Ancona, Barbara Bellini
09.30
Selected LIVE IN THE BOX from SOUTH
AMERICA
Presenters: Alexandre C. Abizaid, Oscar Mendiz
Discussants: Antonio Colombo, Eberhard Grube,
Nicolas Van Mieghem
10.15
CASES PRESENTATION
Chairpersons: Eberhard Grube, Martin B. Leon
Ioannis Iakovou
Athens – Greece
Herbert G. Kroon Rotterdam – The Netherlands
Carlo Briguori, Annamaria D’Achille
Naples – Italy
Eugene Wu
Hong Kong
Giuseppe Venuti
Catania – Italy
Shinji Imura
Shizuoka – Japan
Athanasios Kolyviras
Athens – Greece
Tiziana Attisano
Salerno – Italy
Murugesh S. Hiremath
Pune – India
11.30
Selected LIVE IN THE BOX from EUROPE
Presenters: Georg Nickenig, Azeem Latib
Discussants: Antonio Colombo, Eberhard Grube,
Nicolas Van Mieghem
12.15
Closing remarks and JIM
2019 announcement
JIM Today
Publishing and Production
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Course Directors
Antonio Colombo, MD
Eberhard Grube, MD
Martin B. Leon, MD
Carlo Di Mario, MD
Jeffrey W. Moses, MD
Gregg W. Stone, MD
Nicolas Van Mieghem, MD
Associate Directors
Alexandre C. Abizaid, MD
Seung Jung Park, MD
Stephan Windecker, MD
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Peter Stevenson
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rights reserved. No part of this publication may be
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Organisational Committee.
“The pushability
of a 150-cm
Corsair is much
worse than a
135-cm.”
Paul Hsien-Li Kao
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