Lots of interesting abstracts and cases were submitted for TCTAP 2026. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge!

CASE20250815_001

A Challenging Case Report of Percutaneous Coronary Intervention (PCI) of Complex Chronic Total Occlusion (CTO) Left Anterior Descending Artery (LAD) via Right Distal Radial Access With 5 Fr Ikari

By Sajja Jangjit, Wittawat Wattanasiriporn

Presenter

Sajja Jangjit

Authors

Sajja Jangjit¹, Wittawat Wattanasiriporn¹

Affiliation

College of Medicine, Rangsit University, Division of Cardiology, Rajavithi Hospital, Bangkok, Thailand¹

View Study Report

CASE20250815_001

Coronary - Complex PCI - CTO

A Challenging Case Report of Percutaneous Coronary Intervention (PCI) of Complex Chronic Total Occlusion (CTO) Left Anterior Descending Artery (LAD) via Right Distal Radial Access With 5 Fr Ikari

Sajja Jangjit¹, Wittawat Wattanasiriporn¹

College of Medicine, Rangsit University, Division of Cardiology, Rajavithi Hospital, Bangkok, Thailand¹

Clinical Information

Relevant Clinical History and Physical Exam

Thai male 69 years, Risk HT, DLP presented with chest pain 2 hours prior to admission. BP 104/62 mmHg HR 76 bpm. Heart regular, fine crepitation both lower lungs. EKG showed NSR, 84 bpm, STE II, III, AVF, diffused STD V2-V6. Echo showed LVEF 42%, Global wall Hypokinesia, no significant VHD. Troponin T was positive 10,400 pg/ml. Chest x-ray showed cardiomegaly, increase pulmonary vasculature.

Relevant Test Results Prior to Catheterization

EKG showed NSR, 84 bpm, STE II, III, AVF, diffused STD V2-V6. Echo showed LVEF 42%, Global wall Hypokinesia, no significant VHD. Troponin T was positive 10,400 pg/ml. Chest x-ray showed cardiomegaly, increase pulmonary vasculature.

Relevant Catheterization Findings

- LM: non significant stenosis- LAD: Subtotal occlusion mid-LAD, CTO m-dLAD.- LCx: CTO mLCx with collateral from OM1.- RCA: Total occlusion pRCA with collateral from LCA.

Interventional Management

Procedural Step

PCI to culprit RCA via Rt radial.GD: 5 Fr Ikari Stenting p-d RCA with Resolute integrity 2.5 x 22 mm upto 12 atm. The patient still had chest pain then stage PCI to CTO LAD with Rt DRA. Staged PCI to CTO LAD via Rt DRA.GD: 5 Fr Ikari Sion with finecross pass to LAD then change to Fielder XT pass through CTO LAD.Tip injection revealed true lumen wiring .SC balloon 2.0 x 15 mm inflated p-dLAD upto 14 atm.Xience ProA 2.5 x 38 mm deployed m-d LAD upto 12 atm. Resolute integrity 2.75 x 30 mm deployed p-m LAD upto 12 atm. Acceptable angiographic result.

Case Summary

1. DRA is a feasible and safe alterative for complex PCI.2. Complex CTO LAD can be successfully treated with a right DRA and a 5 Fr Ikari .3. PCI for CTO using a 5 Fr radial Ikari can be successful in selected cases.

E-Case

CASE20250815_001