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-082
Star Technique as a Bail Out or Part of Intended Strategy
By Erwin Mulia
Presenter
Erwin Mulia
Authors
Erwin Mulia1
Affiliation
Ahmad Yani Metro Hospital, Indonesia1,
View Study Report
TCTAP C-082
Coronary - Complex PCI - CTO
Star Technique as a Bail Out or Part of Intended Strategy
Erwin Mulia1
Ahmad Yani Metro Hospital, Indonesia1,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
A 54 year old male was referred to our hospital with symptomatic recent myocardial infarction. Echocardiogram showed reduced left ventricular ejection fraction of 41% with regional wall motion involving all coronary regions. He was discharged with dual antiplatelet, ramipril 5 mg, nitrates 2.5 mg, atorvastatin 20 mg. Coronary angiogram revealed triple vessel disease and percutaneous coronary intervention was performed in the LAD and in the LCx. RCA lesion was staged.
Relevant Test Results Prior to Catheterization
Relevant Catheterization Findings
Coronary angiogram revealed triple vessel disease and percutaneous coronary intervention was performed by implanting one DES in the LAD and one DES in the LCx. RCA lesion was staged.
Interventional Management
Procedural Step
(JL 3.5) 6 Fr guiding catheter and (AnyReachC 0.6) guidewire were used to cannulate and wire the LAD. (JR 3.5) 6 Fr sidehole guiding catheter and (Pilot 150) guidewire were used to cannulate and wire the RCA. The guidewire went extraplaque and intraplaque, so Subintimal Tracking and Reentry (STAR) technique was chosen. Predilation using semi compliant balloon (Sapphire) 1.0 x 10 mm and (Emerge) 1.5 x 15 mm. The procedure was then concluded. Two and a half month after, we reintervene the RCA lesion. (JL 3.5) 6 Fr guiding catheter and (BMW) guidewire were used to cannulate and wire the LAD. (JR 3.5) 6 Fr sidehole guiding catheter and (AnyReachC 1.0) guidewire were used to cannulate and wire the RCA. The guidewire finally went intraplaque. Predilation using semi compliant balloon (Euphora) 1.5 x 10 mm and (Emerge) 2.0 x 20 mm was performed. Stenting was performed using DES (Eucalimus) 3.5x48 mm and DES (Promus Premier Select) 3.5x16 mm. Further dilation at the distal RCA was done using semi compliant balloon (Emerge) 2.0 x 20 mm and (Emerge) 2.5 x 20 mm.
Case Summary
Nowadays, Subintimal Tracking and Reentry (STAR) technique is used not only for bailout strategy but can be considered as first step strategy before completing the CTO intervention. This technique can be used as intended stepwise strategy especially in complex CTO intervention.