The aortic programme at the 2024 Charing Cross (CX) Symposium (23–25 April, London, UK) promises to be “packed with new data” to fuel the debate over controversies in the aortic space.
This is according to CX Executive Board member Tilo Kölbel (University Heart Center Hamburg, Hamburg, Germany), who spoke alongside the recently appointed CX co-chairs Dittmar Böckler (University Hospital Heidelberg, Heidelberg, Germany) and Andrew Holden (Auckland City Hospital, Auckland, New Zealand) in a CX Vascular Live broadcast that previewed the upcoming edition of the event.
The trio spoke upon the release of the CX 2024 preliminary programme, which offers a glimpse of what to expect from the three days of education, evidence and innovation in the treatment of aortic disease. The aortic segment of the CX Symposium—which Kölbel describes as one of the strongest he has seen in the symposium’s history—begins on Tuesday 23 April with a deep dive into aortic techniques and technologies, followed by a full day of presentations, debate and discussion of controversies in juxtarenal and aortic pathologies on Wednesday 24 April, followed by aortic arch and dissection controversies on Thursday 25 April. Alongside these main sessions, Alexander Zimmermann (University Hospital Zürich, Zürich, Switzerland) will be reprising the hands-on aortic workshop that aims to promote learning in an interactive setting.
“On the one hand we are going to have a very similar setup of sessions divided into techniques and technologies on [the] Tuesday,” Kölbel said of the opening day highlights. The focus will be on new devices and techniques, he explains, with an emphasis on edited cases. The focus on Wednesday and Thursday will switch to more “evidence-based” discussion.
“The most important thing is that this is a controversies year, so the focus will be on the debates,” explains Kölbel. “We have picked a number of very important discussions at the moment and very good discussants to help us answer important questions like what to do with juxtarenal aneurysms and how to treat them, the right minimal volume for aortic practices, balloon-expandable versus self-expanding stents, polymer-based filling technologies, and spinal cord drainage in thoracoabdominal repair.”
The abdominal aortic aneurysm (AAA) segment of the programme, which takes place on Wednesday 24 April, features two Great Debates, with speakers debating the best treatment for juxtarenal AAAs, including motions in favour of fenestrated endovascular aortic repair (FEVAR) or endovascular suture aneurysm repair (ESAR), as well as the volume-outcome relationship of AAA repair calls for a combined recommendation of endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) hospital volumes.
Alongside the controversies and debates, innovation will play a key role in the 2024 event, Holden says. “To touch on a few things, we are getting some new data on the branched graft technologies that we are seeing. Not only in the arch, which we are seeing an explosion in technologies, including off-the-shelf options for treating complex arch disease, but also some alternative technologies to manage that juxtarenal segment as well,” he explains.
Imaging technologies, including 3D imaging software and intravascular ultrasound, are also likely to be an important feature, Holden adds, as well as technologies geared towards the prevention of aortic disease progression.
“We have been really interested in some technologies that are treating aneurysms that are sub-threshold, to prevent them ever getting to the threshold to need treatment,” Holden details. “Multiple centres around the world have been involved, and some very early data were presented last year for the first time. At Charing Cross, a symposium was run on small aneurysm treatment globally and this year we plan to carry on that with an updated result on technologies which have shown some great promise.”
Turning to the thoracoabdominal portion of the programme, Böckler highlights that the unanswered question of how to treat patients with uncomplicated type b dissections will be addressed. Furthermore, a great debate will seek to establish whether best medical treatment remains the standard for uncomplicated acute type B aortic dissection.
“It is still a burning question, [that is] not answered yet, we have two randomised trials, and Charing Cross has always been the symposium to get the newest evidence and we are going to see and listen to new trials coming up,” says Böckler.
Crucially, explains Böckler, the programme features 90 presentations, eight great debates and 15 first-to-podium presentations which continue the legacy of innovation, education and evidence that the Symposium has embodied throughout its 45-year history.
Outside of the aortic programme, a full schedule of sessions will dig into the current controversies in all vascular domains, spanning peripheral, venous, acute stroke and vascular access, punctuated by CX debates, live and edited cases and workshop demonstrations. In 2024, CX comes from a brand-new location, the ExCeL convention and exhibition centre in London’s Docklands.