Lower Extremity CTO Interventions

Training Overview

Lower Extremity CTO Interventions Training is a focused, simulation-based educational program designed to strengthen clinical decision-making and technical proficiency in endovascular recanalization of chronic total occlusions (CTO) in peripheral artery disease. This one-day intensive training combines lesion morphology evaluation, advanced wire-crossing algorithms, case-based learning, and high-fidelity simulations to support safe, effective, and limb-saving revascularization strategies.

The program begins with essential modules on CTO lesion characteristics, cap morphology assessment (blunt vs. tapered, calcified caps), and multi-modality pre-procedural imaging review (CTA and DSA). Participants review systematic step-by-step crossing algorithms, guidewire-microcatheter combinations, and gain a structured approach to selecting optimal access sites and crossing techniques in daily practice.

Simulation-based sessions focus on antegrade true-lumen crossing, controlled subintimal tracking, and the utilization of dedicated re-entry devices. Intensive hands-on workshops cover alternative access techniques—including retrograde pedal or popliteal access—dual-access techniques, vessel preparation (atherectomy and specialized balloons), and definitive therapy selection (DCB, DES, or covered stents).

Advanced case discussions address challenging scenarios in chronic limb-threatening ischemia (CLTI) patients, heavily calcified femoropopliteal and infrapopliteal occlusions, and long-segment disease. Integrated simulations emphasize crisis management for acute intraprocedural complications, including severe vessel perforation, acute dissection, distal embolization, and access-site bleeding.

By the end of this intensive program, participants will be able to confidently select appropriate crossing strategies, deploy re-entry devices, and execute lower extremity CTO interventions safely while effectively preventing and managing potential complications.

Target Audience

• Vascular Surgeons

• Interventional Cardiologists

• Interventional Radiologists

• Vascular, Cardiology, and Radiology Fellows and Residents

• Cath Lab and Endovascular Suite Specialist Nurses, Technologists, and Program Coordinators

  
  

Training Specifics

• Training Name: Lower Extremity CTO Interventions Training

• Duration: 1 full day

• Language: English

• Simulation Lab: High-fidelity peripheral CTO simulators, re-entry catheter deployment labs, retrograde pedal access workshops, crisis scenarios

• Assessment Type: Quiz & practical evaluation

• Certificate: Certificate of Completion & CME Credits

• Program Venue: ADN CoE Training, Research Center & Core Lab

  
  

Additional Benefits

• Simulation-Based Learning: Practice complex CTO crossing, re-entry deployment, and complication troubleshooting in realistic clinical scenarios.

• Hands-On Device Lab: Master specialized CTO crossing wires, microcatheters, re-entry devices, and atherectomy systems.

• Antegrade & Retrograde Focus: Learn techniques for pedal and popliteal retrograde access, wire knuckling, and SAFARI techniques.

• True-Lumen Re-Entry Mastery: Perfect the conceptual steps and technical execution of re-entry device positioning and target acquisition.

• Crisis Management Training: Rapidly respond to arterial perforations, acute thrombotic occlusions, and distal atheroembolism.

• Expert Faculty Guidance: Receive practical technical pearls, wire-selection strategies, and real-time procedural feedback.

  
  

Key Benefits

• Improved interpretation of CTO cap morphology and calcification patterns.

• Higher success rate in navigating challenging femoropopliteal and infrapopliteal occlusions.

• Enhanced technical capability in executing retrograde access and re-entry maneuvers.

• Greater confidence during complex limb-salvage and endovascular revascularization procedures.

• Strengthened multidisciplinary clinical decision-making across peripheral endovascular care teams.

  
  

Ethical and Educational Standards

All ADN CoE training programs are designed in compliance with ethical, animal-free, and environmentally responsible education policies, ensuring clinical excellence and sustainability. For inquiries regarding accreditation or ethical compliance, contact trainings@adncoe.com.  

Logistics and Additional Information

Transfer Services

Participants using ADN CoE accommodation and transfer options should adhere to the scheduled pick-up and drop-off times, which were shared before the training.

International Participants

Ensure your passport and visa are valid before travel. For invitation letters or official documentation, contact trainings@adncoe.com at least 4 weeks before the course start date. Information on nearby hotels, transport, and regulations will be provided before the event.

Attire

Business casual attire is recommended. Clinical scrubs and personal protective equipment will be provided for simulation and imaging workstation lab sessions. Please note: ADN CoE is a non-smoking, green-certified facility.

Health & Safety

Our venues comply with the highest safety and hygiene standards. Participants will receive orientation on fire, emergency, and biosafety protocols.

Transfer of Registration

Participants may transfer their registration to another individual from the same institution with prior written approval from ADN CoE, provided the request is made at least 10 days before the course start date.  

Course Postponement or Cancellation

ADN CoE reserves the right to postpone or cancel the course due to unforeseen circumstances. In case of cancellation by ADN CoE, participants will receive a full refund or the option to transfer to a future course date.  

Non-Transferable Fees

Payment made for the course is non-transferable to other courses or services unless otherwise approved by ADN CoE.

Faculty Disclosure and Conflict of Interest

All faculty members and proctors involved in this training disclose any financial or commercial interests. We maintain a strict policy of no conflict of interest with device companies, sponsors, or participants, ensuring unbiased and independent education.  

Content Independence

The educational content is developed based solely on the latest scientific evidence and clinical best practices. No product promotion or commercial advertising is included in our training materials.

Evaluation and Feedback

We value your input. At the end of the course, you will be invited to complete a feedback survey and a knowledge assessment quiz. Your responses help us continually improve the training experience.

Quality Assurance

Our training materials and curriculum are regularly reviewed and updated to reflect the most current research and technological advances in the field.

Sponsorship Transparency

Any sponsorship or funding received for this course is disclosed upfront. We ensure that sponsors do not influence the content or delivery of the training.

Data Protection and Patient Confidentiality

We strictly protect the privacy of all participants and uphold the highest standards of confidentiality regarding patient information shared during the training, in accordance with applicable data protection laws.  

Accessibility and Inclusiveness

We strive to make our training accessible to all participants. Language support and accommodations for disabilities are available upon request to ensure an inclusive learning environment.  

Please note that our training is specialized procedural training provided by ADN CoE. They are independent of any other training offered by relevant device companies.