Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-087
PCI of RCA in Undersized, Unexpended DES ISR
By Hariom Tyagi
Presenter
Hariom Tyagi
Authors
Hariom Tyagi1
Affiliation
Lokpriya Hospital, India1,
View Study Report
TCTAP C-087
CORONARY - Complex and Higher Risk Procedures for Indicated Patients (CHIP)
PCI of RCA in Undersized, Unexpended DES ISR
Hariom Tyagi1
Lokpriya Hospital, India1,
Clinical Information
Patient initials or Identifier Number
1233YS
Relevant Clinical History and Physical Exam
A 60 years old male patient presented here with complain of Dyspnoea, heaviness in chest, associated with generalized weakness since 10 days, symptoms increased 1-2 days prior to admission. H/O: T2DM/CAD/POST PTCA to RCA (2010).
Relevant Test Results Prior to Catheterization
ECG shows Old inferior infarct.
Relevant Catheterization Findings
His Angiogram revealed – Left Main with SVD: Left Main: Ostium 40% disease. LAD: Type III vessel. Proximal to Mid ectatic artery. D1/D2: Normal. LCX: Non-dominant, Normal. OM1/OM2: Normal. RCA: Dominant, Diffuse and ISR with mid 95% restenosis. PLV/PDA: Normal.
Interventional Management
Procedural Step
PTCA TO RCA: Right Coronary Artery was engaged with JR 3.5, 6F guide catheter. A 0.014” RUNTHROUGH Coronary wire was used to cross the RCA lesion. Pre Dilatation done with sprinter balloon 2.0 x 10 & 3.0 x 9 mm @ 14 atm. Drug eluting Stent YUKON CHOICE PC ELITE 4.0 x 40 mm was deployed in mid RCA @ 16 atmosphere. Post dilatation done with NC sprinter balloon 4.5 x 8 mm @ 22 atm. GP IIb IIIa inhibitor was used during the procedure. Excellent result with TIMI III flow achieved. Successful PTCA with stenting RCA.
Case Summary
Restenosis post PCI remain one of the most challenging lesions particularly for the side branches in terms of long term procedural success rate. Drug eluting balloon provide novel therapeutic strategy for restenosis. In-stent restenosis is the most important limitation of modern coronary angioplasty. Drug-eluting stents solve this problem but at the cost of late stent thrombosis and longer duration of dual-antiplatelet therapy. Drug-eluting balloon (DEB) technology is now available and offers an attractive option for treatment of restenosis.