Budapest Complex Endovascular Interventions

PROGRAM OVERVIEW

Hall A — Coronary Track

Hall B — Peripheral Track

This meeting is designed as a practical, case-based CHIP/CTO course with live cases, live-in-a-box sessions, decision labs, and hands-on workshops.

DAY 1 — THURSDAY, 9 JULY 2026

08:00–08:40 | Registration and Welcome Coffee

08:40–09:00 | Opening Ceremony (Main Hall)
Welcome remarks
Béla Merkely, Zsolt Piroth, Zoltán Ruzsa

HALL A — CORONARY CHIP & PLAQUE PREPARATION

09:00–10:00 | Session 1. Heart Team and Planning in CHIP (Debate Session)

09:00–09:20 Heart Team for CHIP: patient selection, frailty, LV dysfunction, valve disease

• Surgical perspective
• Interventional perspective

09:20–09:45 CHIP planning: which modality changes strategy?

• Coronary CT for procedural planning
• Functional guidance
• Intracoronary imaging guidance

09:45–10:00 Panel discussion and audience polling

• LIVE CASE FROM JAPAN

10:00–10:30 | Coffee Break

10:30–11:15 | Session 2. Imaging, Physiology and AI in Coronary Intervention

• AI for angiography, physiology, IVUS/OCT workflow support
• Automated calcium scoring, sizing, expansion metrics
• Validation, pitfalls, medico-legal considerations

11:15–12:00 | Live-in-a-Box Coronary Case
Calcified left main / bifurcation / high-risk PCI case with full strategy narration
LIVE CASE FROM HUNGARY

12:00–13:00 | Lunch

13:00–14:30 | Session 3. Coronary Plaque Preparation Toolbox

• 13:00–13:20 NC, cutting, scoring and OPN balloons
• 13:20–13:40 Intravascular lithotripsy
• 13:40–14:00 Rotational atherectomy and rota-cut strategy
• 14:00–14:20 Orbital atherectomy
• 14:20–14:30 Discussion: choosing the right calcium device

14:30–15:00 | LIVE CASE / Recorded Expert Case
Calcified coronary lesion preparation with imaging guidance

15:00–15:20 | Coffee Break

15:20–16:20 | Session 4. What to Do After Plaque Preparation?

• Drug-coated balloon strategy
• Drug-eluting stent optimization
• Bioresorbable scaffold: niche or comeback?
• Summary debate: best strategy after calcium modification

16:20–17:20 | Session 5. Hemodynamics and Mechanical Circulatory Support in High-Risk PCI

• Protected PCI: when do we really need MCS?
• Impella / iVAC
• ECMO-supported PCI
• Building a protected PCI program

17:20–17:40 | Day 1 Coronary Wrap-Up
Top 10 practical pearls

HALL B — PERIPHERAL ACCESS, PLAQUE PREPARATION AND CTO WORKSHOPS

09:00–10:00 | Session 1. Peripheral Strategy for Complex Endovascular Cases

• CLTI pathway and limb salvage team
• Duplex, CTA and angiographic planning
• WIfI and GLASS in real-life decision-making

10:00–10:30 | Coffee Break

10:30–11:15 | Session 2. Peripheral Access Strategy

• Antegrade CFA access
• Pedal / tibial / popliteal access
• Radial-to-peripheral strategy
• Hemostasis and bailout principles

11:15–12:00 | Live-in-a-Box Peripheral Case
Pedal access femoro-popliteal / BTK CTO recanalization

12:00–13:00 | Lunch

13:00–14:30 | Practical Workshop Block 1 (Rotating Stations)

• Station 1: Ultrasound-guided CFA access and closure
• Station 2: Pedal and popliteal access simulation
• Station 3: Femoro-popliteal CTO crossing and re-entry
• Station 4: Tibial CTO wire and catheter skills

14:30–15:00 | Coffee Break

15:00–16:15 | Practical Workshop Block 2 (Rotating Stations)

• Station 5: Peripheral plaque preparation: scoring, specialty balloons, IVL
• Station 6: Atherectomy planning and embolic protection
• Station 7: Complications lab: perforation, distal embolization, acute thrombosis
• Station 8: Duplex and angiographic endpoint interpretation

16:15–17:15 | Interactive Case Theater

• Rapid-fire CLTI and complex peripheral cases
• Fem-pop CTO
• Tibial multilevel disease
• Access-site bailout
• Reintervention strategy

17:15–17:30 | Day 1 Peripheral Wrap-Up

19:00 | Faculty Dinner

DAY 2 — FRIDAY, 10 JULY 2026

HALL A — CORONARY CTO DAY

08:30–09:00 | Coffee and Day 1 Highlights

09:00–10:00 | Session 1. CTO Indications, Evidence and Patient Selection

• Medical therapy versus PCI
• Symptom-driven and ischemia-driven indications
• What outcomes can realistically be improved?
• When not to treat a CTO

10:00–11:00 | Session 2. CTO Anatomy and Angiographic Interpretation

• CTO definition and morphology
• Proximal cap, distal landing zone, calcification, tortuosity
• Dual injection and roadmap planning
• Choosing the first strategy

11:00–11:20 | Coffee Break

11:20–12:00 | Session 3. CTO Equipment Basics

• Access planning: radial, bilateral radial, femoral, mixed
• Guide catheter support
• Microcatheters
• Polymer-jacketed, tapered and penetration wires
• Guide extensions, trap balloons, torque devices

12:00–13:00 | Lunch

13:00–14:15 | Session 4. Antegrade CTO Recanalization

• Wire escalation principles
• Knuckling versus controlled drilling
• True lumen confirmation
• When to change strategy
• Antegrade dissection-re-entry: concepts and pitfalls

14:15–15:00 | Live Case / Live-in-a-Box CTO Case
Straightforward antegrade CTO with full decision commentary

15:00–15:20 | Coffee Break

15:20–16:00 | Session 5. Retrograde CTO Recanalization

• Septal versus epicardial collateral channels
• When retrograde should be considered
• Externalization principles
• Safety boundaries for new CTO programs

16:00–16:45 | Session 6. Intravascular Imaging and CTO Optimization

• IVUS for cap definition and stent optimization
• Coronary CT in selected cases
• Minimal standards for final result

16:45–17:30 | Session 7. CTO Complications and Bailout

• Perforation and tamponade
• Donor vessel injury
• Radiation and contrast discipline
• Entrapped equipment
• When to stop safely

17:30–17:45 | Coronary CTO Summary

HALL B — PERIPHERAL CTO / CLTI / COMPLEX ENDOVASCULAR DAY

08:30–09:00 | Coffee and Day 1 Highlights

09:00–09:45 | Session 1. CLTI and Complex Peripheral Disease

• Limb salvage strategy
• When to prioritize inflow, fem-pop, or BTK
• Multidisciplinary coordination: wound care, diabetology, vascular surgery

09:45–10:30 | Session 2. Device Selection in Peripheral Calcified Disease

• DCB versus DES
• Specialty balloons and IVL
• Atherectomy: when and why
• Vessel preparation in fem-pop and BTK disease

10:30–10:50 | Coffee Break

10:50–11:30 | Session 3. Crossing and Re-entry for Peripheral CTO

• Intraluminal versus subintimal techniques
• Fem-pop CTO crossing
• Tibial CTO strategy
• Re-entry devices and bailout maneuvers

11:30–12:00 | Live-in-a-Box Peripheral CTO Case
CLTI with pedal access, tibial CTO crossing and definitive treatment

12:00–13:00 | Lunch

13:00–14:15 | Practical Workshop Block 3 (Rotating Stations)

• Station 1: Fem-pop CTO crossing and re-entry
• Station 2: Tibial CTO preservation techniques
• Station 3: Distal access and hemostasis
• Station 4: Complication management simulation

14:15–14:35 | Coffee Break

14:35–15:35 | Session 4. Post-Procedure Strategy and Surveillance

• Antithrombotic therapy after peripheral intervention
• Duplex follow-up and restenosis detection
• Reintervention triggers
• Wound surveillance and multidisciplinary care

15:35–16:20 | Case Theater
My worst CLTI case: what went wrong, how it was fixed, lessons learned

16:20–17:00 | Debate Session

• Atherectomy in fem-pop disease: pro versus con
• Radial-to-peripheral: routine or niche?

17:00–17:20 | Awards and Closing Remarks (Main Hall)

• Best Coronary Case
• Best Peripheral Case
• Best Complication Save
• Next meeting announcement

PRACTICAL WORKSHOPS

• Coronary Workshops
• Coronary CT planning workshop
• IVUS/OCT optimization workshop
• Atherectomy workshop
• CTO wire skills and microcatheter support
• ADR concepts and re-entry simulation
• Large-bore access and MCS troubleshooting
• Peripheral Workshops
• Ultrasound-guided CFA access
• Pedal / tibial / popliteal access simulation
• Peripheral CTO crossing and re-entry
• Plaque preparation in calcified fem-pop lesions
• BTK intervention planning
• Hemostasis and access-site bailout lab