Professor Roger Greenhalgh, chairman of the CX Programme Organising Board, outlines the most exciting developments and controversial topics in the vascular and endovascular field to be explored at the upcoming Charing Cross Symposium.
Arch and thoracic aorta
The field of ascending aortic interventions has developed fast in the last few years and procedures in this area have become mainstream. New devices for the aortic arch will be unveiled at CX 2015. For the descending aorta, a new thoracoabdominal device, first used in Brazil in two procedures, will be presented.
Additionally, a debate entitled “The heyday of open aortic surgery is over” focuses the audience on the realisation that the whole of the aorta can now be replaced by endovascular means – but should they?
The controversies in the thoracic arena will address the questions: Should we intervene in chronic type B dissections? What is the best approach for the management of juxtarenal aneurysms? And how valuable is the “hybrid graft”?
The latest data in the field will be presented at CX 2015!
Abdominal aortic aneurysms
You will have the opportunity to see for the first time the 12-month results of IMPROVE, the latest randomised controlled trial for the use of EVAR for aortic rupture. It will be published at once in the European Heart Journal.
Also for the first time, 12-month Individual Patient Data (IPD) meta-analysis on the three randomised controlled trials for ruptured aortic aneurysm will be presented.
In the abdominal aortic field one of the main controversies is the management of abdominal aortic aneurysm with challenging morphology and a neck of less than 15mm. Therefore, different treatment options in the field will be discussed.
You will also hear about the latest controversies in the management of type I endoleaks and controversies in AAA follow-up addressing whether the use of polymer filling of devices is a game changer.
The struggle for optimal sizing and choice of device for each situation goes on. Results relate to these choices. So a NEW CX Edited Live Cases session of 10 technical demonstrations supports the main thoracic and abdominal aortic programmes to emphasise the importance of using the right device for the right situation.
Peripheral Arterial Controversies
In CX 2015, the controversies of treatment of the superficial femoral artery fall conveniently into the three groups – “leaving nothing behind”, “leaving something in” or open bypass surgery.
These concepts are aired on the first CX Peripheral Main Programme day. The techniques are demonstrated in the NEW CX Live Peripheral Arterial Cases session by Professor Thomas Zeller in Bad Krozingen. This will be recorded online and roundtable discussions on these topics will be held in the ilegx Collaboration Day by world experts.
Increasing lesion length affects the choice of methods used for reconstruction of the superficial femoral artery.
It is at CX 2015 controversies year that surgeons of the BASIL 2/3 trial and the BEST trial speak in terms of five-year patencies. What of endovascular six and 12-month follow-up triumphs? How will the CX audience react to this dilemma? Your opinion and vote will be counted at CX 2015.
Less controversial is the need to understand thoroughly the interdisciplinary management needs of the diabetic foot with ulceration, especially from type 2 diabetes mellitus.
Expert care is taught at CX with a recommendation for rapid revascularisation with latest techniques.
Below-the-knee technologies are usually reserved for severest of leg ischaemias. These techniques will be demonstrated live.
The CX Venous Main Programme addresses the superficial and deep venous systems and both are demonstrated in the two-day NEW CX Venous Workshop.
Superficial venous controversies
The superficial venous controversies are no longer between surgery and office-based techniques. Now the controversy seems to be about which method to select in which situation. It comes down to thermal and non-thermal techniques. Thermal techniques include radiofrequency ablation and endovenous laser therapy. Non-thermal techniques include mechanochemical ablation, glues and foam sclerotherapy.
Cosmetic thread vein treatment with sclerotherapy and laser therapy will be discussed, as well as the role of imaging in superficial venous treatment.
Deep venous controversies
The role of imaging will also be explored in deep venous treatment, as well as interventions of deep venous reconstruction by stent and catheter-directed thrombolysis and thrombectomy.
The NEW CX Venous Workshop will give delegates the opportunity to learn in one-to-one practical training sessions and see demonstrations of techniques to correct superficial and deep venous problems presented in the CX Main Programme.
The CX Venous Workshop Faculty are hand-picked experts in the technique they demonstrate.
CX 2015 will take place in two weeks. See you in London!
Download the Final Programme here.