Japan, especially CCT, has been developed its original treatment strategy for CTO lesions in contrast to other countries where “antegrade approach” which considers utilization of knuckle wire technique in primary selection of polymer jacket wire, and “retrograde approach” which uses surfing technique more than in searching connecting vessels by tip injection, have become the mainstream of treatment strategies.

As an effort to depict lesions missed by angiography, which is the essence of CTO lesions, the way to understand vascular courses using cardiac CT and IVUS has been established as a reproducible method. Furthermore, due to development of AI, you can depict perpendicular view as well as find direction of a wire as angiography by using apps. (Espelux Edu software, 3D wiring) IVUS is now useful not only to check vascular course (wire placement) but also to guide a wire properly. (Tip detection method) We would like you to learn these evolutions, current achievements and tips through various contents centered on Live Case Transmissions.

On the other hand, considering the situation in Japan, the number of ACS lesions with complex anatomy and less vascular flow reserve has increased. Even though many of these lesions are presumably treated by young doctors during nighttime, it is essential to acquire knowledge and techniques of complex PCI in order to treat these lesions at any time.
As it is already stated, there are some differences in techniques for complex PCI such as CTO lesions between Japan and foreign countries. Therefore, having discussions with doctors from all over the world in sessions such as Live Case Transmissions will lead to doubt or confirm your common sense and to expand new perspectives.
Although we have variety of live courses including online in Japan, we believe that CCT is the only course which is able to contribute from this point of view. Please participate on site actively and make full use of this opportunity for energetic exchange with domestic and international participants and expand your perspective.

In addition, we are planning to prepare a program which appeals directly to next-generation doctors’ and medical staffs’ motivation for participation. An exchange using SNS is a modern trend and very convenient, but a humane exchange with eye-to-eye contact on site also has character. We hope you will enhance your complex PCI through various programs.

We are looking forward to welcoming you in Kobe when autumn is in full swing.

CCT2026 Representative Coronary Course Director
Kazuhiro Ashida (Seirei Yokohama Hospital)