We have been investigating complex PCI for approximately 20 years. At the beginning, the main targets were LMT lesions and CTO. Twenty years ago, it was difficult to perform PCI for LMT lesions. If it was selected without a good reason, fierce criticism would be unavoidable. At present, nobody is surprised when PCI is applied to LMT lesions. On the contrary, large-scale studies have suggested that PCI can be more appropriate than CABG depending on the case. Use of PCI for CTO was also criticized by many researchers, but it is presently performed worldwide because the long-term outcome of PCI for CTO has improved dramatically thanks to DES. However, improvement of the early outcome is a problem that remains to be solved. When only the antegrade approach was available for CTO, the success of treatment depended greatly on the skill of the operator, so it was difficult to obtain reproducible results. However, thanks to adoption of the retrograde approach, the early success rate has shown significant improvement over the last few years. Moreover, various devices have been developed and the procedure has been standardized. At present, PCI for CTO appears to be entering a period of standardization, transmission of skills, and education. This trend is not confined to CTO. During TOPIC 2012, challenging PCI for complex cases will be discussed as before, but attention will be focused on the logical employment of PCI based on standardization.

Another important subject is the development of human resources for the future. During the present TOPIC, I saw that the sessions for young physicians were really exciting. We will continue to provide information to physicians who do not have much experience with PCI or who are just starting to learn PCI. Of course, some experience is essential for successful PCI, but increasing your experience will not always improve your skills. Knowledge and clear thinking are more important than experience alone. When a difficulty or complication arises, the operator who has more options can more adequately solve the problem. Moreover, it may be possible for them to avoid such problems in the first place.

We also attach importance to the co-medical sessions, because the skills of technicians, ME, nurses, and physicians should be improved to achieve satisfactory PCI. We are drawing up new plans to offer more complete sessions during TOPIC 2012. If you have any good ideas, please advise us in order to enrich the three days available for TOPIC 2012.

Best regards.

TOkyo Percutaneous cardiovascular Intervention Conference

Course Director
Yasushi Asakura, M.D
Toshiya Muramatsu, M.D
Masato Nakamura, M.D
Masahiko Ochiai, M.D