CX 2017 Main Programme Highlights

Pathways of Care

This year CX completes another cycle of Controversies, Challenges and Consensus and in 2017 it will continue to focus on EDUCATION, INNOVATION and EVIDENCE in order to reach CONSENSUS in all aspects of vascular disease management. In all sessions CX will address “Pathways of Care”, and the audience will hear presentations in all of the vascular domains on:

      WHETHER to intervene and benefit from it

      WHEN to intervene and at what threshold

      INTERVENTION METHOD and evidence

      FOLLOW-UP and outcomes of intervention

Peripheral Arterial Consensus Update, including:

Acute ischaemia

  • Mechanical thrombectomy and thrombolysis

Internal iliac artery

  • When to deploy an iliac branched device
  • Iliac aneurysm repair – the relevance of the second side

Superficial femoral artery

  • Vessel preparation before drug-coated balloon use
  • Current guidelines for drug-coated balloons
  • Stents: The value of biometric design and the value of radial strength
  • New trial results: Comparison of two drug-eluting stents and comparison of drug-eluting stent vs. drug-coated balloon

Below the knee

  • “Endovascular first practice” may alter equipoise for below-the-knee trials
  • Differences following open and endovascular management of critical ischaemia using fluorescence imaging

Diabetic foot

  • Point-of-care duplex ultrasound: A paradigm shift in the detection of peripheral arterial disease in diabetes?
  • Microvascular complications of diabetes and implications to cardiovascular risk

Lifestyle

  • Exercise
  • Smoking cessation

Abdominal Aortic Challenges Update, including:

Screening & indications

  • Cardiopulmonary exercise testing predicts perioperative mortality and long-term survival in AAA patients
  • Optimal management of men with small and medium AAA in surveillance
  • Cardiac rehabilitation to improve life expectancy after AAA repair

Threshold

  • Operating below AAA threshold of 5.5cm saves lives – oh, yes? Let us listen to the evidence

Method

  • The consequences of performing fewer open AAA repairs
  • Reducing errors during minimally invasive procedures for elective AAA repair
  • First clinical experience proves that new endografts overcome the current limitation in treating challenging neck
  • Competence in EVAR techniques
  • Safety considerations with hostile neck 10–15mm

Outcomes and follow-up

  • Elective AAA repair – UK hospital data support the EVAR trial results
  • CX Debate on annual imaging
  • Constant checks for type I endoleak and migration
  • Embolisation for type I endoleaks after EVAR? – Mid-term outcomes, pitfalls and patient selection
  • Fabric degeneration and type III endoleaks remain a problem

Mini-symposium on type II endoleaks

  • Validation of a method to define patients at risk for type II endoleak, based on preoperative CT anatomic characteristics
  • What is the transiliac route for the embolisation of type II endoleaks post EVAR? – Technique, when to attempt it and efficacy
  • Systematic review on treatment success for type II endoleak
  • Direct percutaneous sac puncture an easy way to solve type II endoleaks after EVAR

Ruptured aneursyms

  • EVAR simulation for rAAA saves lives
  • Ruptured AAA – the early benefit of EVAR is maintained out to six years, but overall survival remains poor
  • Challenging anatomy predicts short- and long-term mortality and complications after rEVAR
  • Challenging anatomy predicts mortality and complications after EVAR for ruptured AAA
  • How involvement in the IMPROVE trial has altered practice and departmental consensus for open vs. endovascular strategies for repair of ruptured AAA
  • Endovascular aortic repair out of instructions for use in ruptured AAA

Thoracic Aortic Challenges Update, including:

  • Thoracic pathologies and different approaches for each
  • Total endovascular aortic repair

Ascending aortic aneurysm

  • Ascending aortic aneurysm remodelling for various pathologies

Arch aneurysm

  • CX Debate: Branched or fenestrated devices have superceded arch repair as first-line treatment
  • Long-term feasibility data of thoracic single branched endograft in the aortic arch zones 0, 1 and 2
  • Anatomical challenges and TEVAR performance in the aortic arch

Risk of cerebral embolisation after arch procedures:

  • The role of air embolisation in EVAR and TEVAR and strategies to prevent it
  • The use of embolic filters to reduce the stroke risk in TEVAR
  • Gaseous embolisation from the arch

Descending aortic aneurysm

  • CX Debate: Types A and B terms are no longer satisfactory
  • Inflammatory aneurysm – current consensus guidelines do not apply with connective tissue disorders
  • Migration after TEVAR
  • Uncomplicated chronic type B dissection revisited

Juxtarenal

  • ESVS consensus guidelines for descending thoracic aorta management
  • The ESVS Guidelines on the management of diseases of the mesenteric arteries and veins
  • Treatment of complex aortic pathologies using parallel grafts, snorkels and chimney grafts

Radiation dose awareness in aortic interventions

  • Total contrast-free EVAR: dream or reality?
  • Contrast-enhanced cone beam CT for intraoperative quality assessment during endovascular aortic procedures
  • Radiation exposure to operative teams – the need to reduce radiation dose in follow-up
  • Cellular markers of radiation damage during TEVAR
  • The use of IVUS to reduce radiation

Venous Consensus Update, including:

Investigations of superficial and deep venous anatomy

  • The search for the best imaging modality is a worldwide problem
  • CT venography and MR venography are performed in the horizontal position – Suitability for assessing venous function
  • The place of ultrasound for deep venous assessment
  • Value of intravascular ultrasound in venous investigation and radiation reduction

Assessment and interventions of acute and established superficial and deep venous thrombosis

  • Pathways of care for venous stenting interventions
  • Treatment for acute deep venous thrombosis – Pathways of care on the use of catheter-directed thrombolysis and mechanical thrombectomy
  • ATTRACT trial: Medical treatment versus intervention (catheter-directed thrombolysis or mechanical thrombectomy)
  • Surveillance of venous stents

Pelvic vein congestion and reflux

  • Prevalence of venous reflux de novo
  • Distinguishing pathological from natural reflux

Varicose vein management

  • Percutaneous valvuloplasty
  • Biomatrix sclerofoam as a rival for endothermal ablation
  • Predictors of recanalisation after acrylocyanate truncal vein treatment
  • Improved compression techniques
  • PressPatch device to improve working compression pressure

Aesthetic phlebology

  • Optimising cosmetic outcomes for reticular veins and telangiectasis
  • Foam sclerotherapy for reticular veins and telangiectasis

Lymphoedema

  • Modern understanding of primary lymphatic dysplasias and prognosis
  • Modern strategies for imaging in lymphoedema
  • Surgical procedures for lymphoedema

Leg ulceration

  • Modern guidelines for leg ulceration
  • Pathways of care – Early Venous Reflux Ablation (EVRA)

Upper limb/subclavian vein compression

  • Conservative treatment of Paget Schrötter syndrome
  • Treatment of subclavian vein compression/central veins occlusions

Acute Stroke Update, including:

Carotid endarterectomy

  • The decreasing numbers of patients undergoing CEA – is it risk aversion or better medical management?
  • Predicting stroke risk in carotid disease duplex ultrasound criteria including carotid plaque volume
  • What is wrong with current carotid guidelines and why guidelines are misleading

Vertebral artery intervention

  • Rapid interventions are essential (VIST and VAST trials)
  • Sex and age affects the outcomes of carotid endarterectomy and carotid artery stenting
  • The need for co-ordination of services

Intracranial intervention

  • Cerebral micro-embolisation during endovascular aortic surgery – The case for investigating the benefits of carotid protection devices in all endovascular patients, and the need for a consensus on protocols
  • Protocol for patient with stroke after an endovascular aortic arch procedure
  • What the HERMES collaboration tells us about structuring systems of care to provide timely treatment to acute ischaemic stroke patients
  • Aortic arch endovascular procedures and location of stroke care
  • The European experience with mobile stroke units
  • The role of emergency medical service providers in improving stroke pathways of care
  • MR, CT angiography or CT perfusion – which imaging is best?
  • General anaesthesia versus conscious sedation
  • Stent retriever, aspiration, or both
  • New thrombectomy technology
  • Ongoing and upcoming trials

CX Parallel Sessions

The Parallel Sessions of the Charing Cross Symposium offer attendees the opportunity to enhance skills for daily clinical practice in the vascular and endovascular field with educational and practical sessions.

CX Aortic Edited Cases

CX Peripheral Live and Edited Cases 

CX Venous Workshop 

CX Vascular Access Course 

CX Abstract and Poster Sessions 

CX ilegx Interdisciplinary Consensus on Severe Ischaemia 

CX Innovation Showcase 

CX Meets Latin America 

CX Paediatric Issues and Congenital Vascular Malformations

LINC@CX 

CX Second Announcement

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