Course Objective

Recent developments of devices and technical approaches such as the retrograde approach and antegrade dissection re-entry (ADR) have led to a greatly improved success rate for recanalization of chronic total occlusion (CTO). Also, a new algorithm for crossing CTO has been proposed from the Asia Pacific CTO club. The algorithm can help to choose the appropriate strategic approach to CTO PCI and lead to success for recanalization of CTO even in non-expert CTO operators. However, when a difficult case (J-CTO score≧2) is suggested for non-expert CTO operators, it is best to either perform the case with a proctor or refer the case to an expert CTO operator because more depth insight and theoretical procedure are required for success in CTO PCI.

This year marks the 20th anniversary of the CTO Club. The CTO Club has provided the best knowledge and procedure for complex CTO lesions via live demonstrations by Japanese CTO expert operators for 20 years. In recent years, CTO-PCI procedures have been proactively performed worldwide. Joint sessions have been also held with CTO clubs from other countries. The Chinese language live course was extremely popular last year, hence, this live course will be held this year too.

The procedure and methodology of CTO PCI are becoming a mature stage, and the success rate for recanalization of CTO is now beyond 90% according to data from the Japanese Expert Registry. However, there are still some issues that need to technically overcome complex CTO lesions, such as heavily calcified lesions, tortuous lesions and long lesions. The CTO Club will continue to confront and overcome these issues with experts from all over the world for further development. We are looking forward to seeing you at the 20th CTO Club in 2019.

Takafumi Tsuji
The 20th CTO Club Representative Course Director

Course Directors

Yasushi Asakura
(Hakujikai Memorial Hospital)

Yuji Hamazaki
(Ootakanomori Hospital)

Yasumi Igarashi
(Tokeidai Memorial Hospital)

Eisho Kyo
(Kusatsu Heart Center)

Kenya Nasu
(Toyohashi Heart Center)

Masahiko Ochiai
(Showa University, Northern Yokohama Hospital)

Atsunori Okamura
(Sakurabashi Watanabe Hospital)

Satoru Otsuji
(Higashi Takarazuka Satoh Hospital)

Etsuo Tsuchikane
(Toyohashi Heart Center)

Takafumi Tsuji
(Kusatsu Heart Center)

Kinzo Ueda
(Rakuwakai Marutamachi Hospital)

Junji Yajima
(The Cardiovascular Institute Hospital)

Masahisa Yamane
(Saitama Sekishinkai Hospital)

International Course Directors

Emmanouil Brilakis
(Minneapolis Heart Institute, USA)

Ji Yan Chen
(Guangdong Provincial People's Hospital, Institute of Cardiovascular Diseases, People's Republic of China)

Scott Harding
(Wellington Hospital, New Zealand)

Hsien-Li Kao
(National Taiwan University Medical School & Hospital, Taiwan, R.O.C.)

Kambis Mashayekhi
(University Heartcenter Freiburg - Bad Krozingen, Germany)

Eugene Brian Wu
(Prince of Wales Hospital, Chinese University Hong Kong, Hong Kong)

Honorary Co-Directors

Osamu Katoh

Takahiko Suzuki
(Toyohashi Heart Center)




Click the image to download a latest program(PDF).

Update: October 17, 2018

Call for Cases

Case Competition “My most impressive bailout case for complication in CTO PCI”

Submission period: Friday, February 1 - Wednesday, March 20, 2019

Among submitted cases, four exemplary cases will be selected as "oral presentation" at the Case Competition, and other cases with honorable mention will be selected as "poster presentation" during the 20th CTO Club. The best case of the Case Competition will receive an award and the presenter will be invited to be a CTO Club faculty member in 2020.

*Free registration for case presenters.

*Cases can be submitted in English or Japanese.


Pre-registration period: Friday, March 1 – Monday, May 20, 2019

*The 20th CTO Club is using a registration system of “”.
You are required to create your user account at in order to complete registration.

  Pre-registration fee (JPY) On-site registration fee (JPY)
Medical 20,000 (2-day ticket) 25,000 (2-day ticket)
Co-medical 2,000 (2-day ticket) 3,000 (2-day ticket)
Industry 20,000 (2-day ticket) 25,000 (2-day ticket)
*After the pre-registration deadline, you can make online registration with on-site registration fee.

Visa Information

You may be required a visa to enter Japan. It varies by nationality.
Please contact your local embassy or consulate of Japan and process your visa if necessary. We recommend you to have enough time for the visa procedure. You could also obtain some information about the visa to enter Japan from the Ministry of Foreign Affairs of Japan Website (

Invitation Letter

You are requested to complete the registration first to obtain the letter of invitation.
It will be issued on request upon receipt of your payment for the 20th CTO Club pre-registration.
If you need the invitation letter and other documents for VISA application, please contact CTO Club Administration Office ( by May 20. Please note that this letter of invitation does not commit CTO Club to any financial supports with regard to your attendance at the 20th CTO Club.
*5,400 JPY per person will be charged to issue the visa application documents other than the invitation letter.



Under Construction

Future Meetings

CTO Club

The 21st CTO Club in 2020

June 19 Fri. - 20 Sat. 2020

Complex Cardiovascular Therapeutics (CCT)

Complex Cardiovascular Therapeutics (CCT)



October 24 Thu.- 26 Sat. 2019
Kobe International Exhibition Hall, Portopia Hotel


October 22 Thu.- 24 Sat. 2020
Kobe International Exhibition Hall, Portopia Hotel