Lots of interesting abstracts and cases were submitted for TCTAP 2025. 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-179
Revolutionizing Recovery: The CERAB Chronicles in High-Risk PCI
By Huzairi Sani, Mugilan Sundarajoo, Beni Rusani, Afrah Haroon, Shaiful Azmi Yahaya
Presenter
Huzairi Sani
Authors
Huzairi Sani1, Mugilan Sundarajoo2, Beni Rusani3, Afrah Haroon4, Shaiful Azmi Yahaya4
Affiliation
Pantai Hospital, Malaysia1, Northern Heart Hospital, Malaysia2, KPJ Damansara 2, Malaysia3, Institut Jantung Negara, Malaysia4,
View Study Report
TCTAP C-179
Coronary - High-Risk Intervention (Diabetes, Heart Failure, Renal Failure, Shock, etc)
Revolutionizing Recovery: The CERAB Chronicles in High-Risk PCI
Huzairi Sani1, Mugilan Sundarajoo2, Beni Rusani3, Afrah Haroon4, Shaiful Azmi Yahaya4
Pantai Hospital, Malaysia1, Northern Heart Hospital, Malaysia2, KPJ Damansara 2, Malaysia3, Institut Jantung Negara, Malaysia4,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
A 70-year-old female with Type 2 Diabetes Mellitus, hypertension, and dyslipidaemia who presented with very high-risk non-ST-elevation myocardial infarction. Immediate coronary angiogram revealed severely calcified and stenosed vessels involving all vessels including the left main.
Relevant Test Results Prior to Catheterization
ECG - No ST-segment elevation or evolving changes.
Relevant Catheterization Findings
Despite achieving TIMI Grade III flow, she remained symptomatic thus was planned for Intra-Aortic Balloon Pump (IABP) insertion and Coronary Artery Bypass Graft. However, aortic catheterisation with a 0.035” Teflon guidewire failed due to severe, bilateral aortoiliac stenosis (Trans-Atlantic Inter-Society Consensus II D).
Interventional Management
Procedural Step
She underwent Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) where both aortoiliac arteries were accessed via bilateralfemoral arteries, pre-dilated with a 6 x 40mm balloon (9 ATM), and stented bilaterally with7 x 57mm @ 11 ATM. The abdominal aorta was stented with BEGRAFT 12 x 49 mm @8ATM prior to aortoiliac stenting.
Via the same access, RotationalAtherectomy withIABP supportwas performed using ROTAPRO 1.5 burr @ 180k rpm on the LeftMain and Left Anterior Descending arteries followed by 2.5 x 28.0 mm and 3.5 x28.0 mmstenting respectively. The Right Coronary Artery subsequentlyunderwent Rotational Atherectomy using ROTAPRO 1.5 burr @ 170k RPM followed by 3.0x 28 mm stenting proximally, and 2.5 x 30.0 Drug-Coated Balloon deployment distally.
Via the same access, RotationalAtherectomy withIABP supportwas performed using ROTAPRO 1.5 burr @ 180k rpm on the LeftMain and Left Anterior Descending arteries followed by 2.5 x 28.0 mm and 3.5 x28.0 mmstenting respectively. The Right Coronary Artery subsequentlyunderwent Rotational Atherectomy using ROTAPRO 1.5 burr @ 170k RPM followed by 3.0x 28 mm stenting proximally, and 2.5 x 30.0 Drug-Coated Balloon deployment distally.
Case Summary
This case highlights the eminence of peripheral intervention e.g., CERAB prior to complex, multivessel, and high-risk PCI. The availability of peripheral intervention widens treatment options for complex cardiovascular diseases without the need for high-risk surgery.